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目的:探讨后腹腔镜手术治疗肾上腺髓质脂肪瘤的疗效及临床意义。方法:回顾性分析12例肾上腺髓质脂肪瘤行后腹腔镜手术患者的临床资料。患者年龄33～72岁,平均53岁;左侧3例,右侧9例;偶发10例,因阵发性高血压、腰疼检查发现各1例。术前均诊断为肾上腺髓质脂肪瘤,肿瘤直径2～8 cm,平均4.9 cm;其中8例直径大于3.5 cm,4例小于3.5 cm。12例患者均在全麻下行后腹腔镜肾上腺肿物切除术。结果:12例患者手术均获成功,手术时间60～270 min,平均130 min。出血量10～660 ml,平均116 ml。术中无并发症。术后住院4～10天,平均5.6天。随访时间6个月～5年,平均2年,未出现肿瘤复发。结论:采用后腹腔镜手术治疗肾上腺髓质脂肪瘤安全有效,具有创伤小、出血少、住院时间短等优点,可以作为肾上腺髓质脂肪瘤的主要手术方法。
Objective: To investigate the effect and clinical significance of retroperitoneal laparoscopic surgery for adrenal medullary lipoma. Methods: The clinical data of 12 cases with retroperitoneal laparoscopic surgery of adrenal medullary lipoma were retrospectively analyzed. Patients aged 33 to 72 years, mean 53 years old; left 3 cases, right 9 cases; occasional 10 cases, due to paroxysmal hypertension, back pain examination found in 1 case. Preoperative diagnosis of adrenal medullary lipoma, tumor diameter 2 ~ 8 cm, an average of 4.9 cm; of which 8 cases were greater than 3.5 cm in diameter, 4 cases less than 3.5 cm. All 12 patients underwent laparoscopic adrenalectomy under general anesthesia. Results: All the 12 patients were operated successfully. The operation time ranged from 60 to 270 minutes with an average of 130 minutes. Bleeding volume 10 ~ 660 ml, an average of 116 ml. No complications during surgery. After hospitalized 4 to 10 days, an average of 5.6 days. Follow-up time of 6 months to 5 years, an average of 2 years, no tumor recurrence. Conclusion: The retroperitoneal laparoscopic treatment of adrenal lipoma is safe and effective, with less trauma, less bleeding, shorter hospital stay, etc. It can be used as the main surgical method of adrenal medullary lipoma.