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目的:探讨后腹腔镜手术治疗较大肾上腺嗜铬细胞瘤的有效性及安全性。方法:回顾性分析2011年12月~2013年1月收治的5例直径在6cm以上的肾上腺嗜铬细胞瘤患者临床资料:男2例,女3例,年龄20~62岁。左侧2例,右侧3例。有高血压、心悸、头痛、出汗等症状。肿瘤大小6.1~7.5cm,平均(6.8±0.6)cm。合并肾功能不全1例。结果:5例患者均成功施行后腹腔镜手术,手术时间90~185min,平均(130±45)min;术中出血量50~350ml,平均(70±38)ml。术后5~7天出院。术后无严重并发症发生。1例术前肾功能不全患者术后血压仍偏高。术后随访3~15个月,无局部复发及远处转移。肾功能不全患者血压用单药控制良好,余4例血压正常。结论:经充分术前准备及正确术中处理,采用后腹腔镜肾上腺切除术治疗较大肾上腺嗜铬细胞瘤是安全有效的。
Objective: To investigate the effectiveness and safety of retroperitoneal laparoscopic surgery for large adrenal pheochromocytoma. Methods: The clinical data of 5 adrenal pheochromocytoma patients with diameter more than 6cm were retrospectively analyzed from December 2011 to January 2013: 2 males and 3 females, aged from 20 to 62 years. 2 cases on the left and 3 cases on the right. Have high blood pressure, heart palpitations, headache, sweating and other symptoms. Tumor size 6.1 ~ 7.5cm, mean (6.8 ± 0.6) cm. 1 case of renal insufficiency. Results: Laparoscopic surgery was successfully performed in all 5 patients. The operative time ranged from 90 to 185 minutes (mean, 130 ± 45) min. The blood loss was 50 ~ 350ml (mean, 70 ± 38) ml. 5 to 7 days after discharge. No serious postoperative complications occurred. One patient with preoperative renal insufficiency had high postoperative BP. All patients were followed up for 3 to 15 months without local recurrence and distant metastasis. Renal dysfunction in patients with a single control of blood pressure, more than 4 cases of normal blood pressure. Conclusion: After adequate preoperative preparation and correct intraoperative management, retroperitoneal laparoscopic adrenalectomy for the treatment of large adrenal pheochromocytoma is safe and effective.