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目的:节细胞神经瘤为少见疾病,多发于后纵隔和腹膜后,发现于肾上腺部位较为罕见。报告上海长征医院泌尿外科10年间15例接受后腹腔镜手术治疗的肾上腺节细胞神经瘤患者的临床资料,分析其临床特点,评估手术安全性,手术效果及预后。方法:2006年3月~2016年3月,15例肾上腺节细胞神经瘤患者在上海长征医院泌尿外科接受后腹腔镜肾上腺肿瘤切除术治疗。所有手术均采取腹膜后入路,经典三孔法后腹腔镜方式完成。15例患者中,男12例,女3例,年龄17~57岁,平均39岁。肿瘤位于右侧6例,左侧9例;肿瘤最大径2.5~11.0cm,平均(5.8±2.3)cm。结果:15例手术均顺利完成,无中转开放病例。手术时间平均(104.6±40.6)min,术中出血量平均(45.3±20.4)ml,术后恢复进食时间平均(1.5±0.4)d,术后住院天数平均(7.2±0.5)d,未出现围手术期并发症。所有病例经术后病理确诊为肾上腺节细胞神经瘤。随访1~96个月,未发现肿瘤复发及远处转移。结论:肾上腺节细胞神经瘤是一种少见肾上腺肿瘤,可通过影像学检查初步诊断。对于<6cm以下的肾上腺节细胞神经瘤,后腹腔镜肿瘤切除术是一种安全有效的微创手术方式。对于>6cm的肿瘤,手术风险增大,对术者的手术经验和技术要求明显提高。
Purpose: Section of the cell neuroma is a rare disease, multiple in the mediastinum and retroperitoneum, found in the adrenal site is relatively rare. Report of Shanghai Changzheng Hospital, Department of Urology, 10 cases of laparoscopic surgery in 15 cases of adrenal ganglioneuroma patients with clinical data, analysis of its clinical features, evaluate the safety of surgery, surgical outcomes and prognosis. Methods: From March 2006 to March 2016, 15 patients with adrenal ganglioneurocytoma underwent laparoscopic adrenalectomy in Department of Urology, Shanghai Changzheng Hospital. All operations were taken retroperitoneal approach, the classic three-hole laparoscopic method to complete. Among the 15 patients, there were 12 males and 3 females, aged from 17 to 57 years, with an average of 39 years. The tumor was located on the right side in 6 cases and on the left side in 9 cases. The maximum diameter of the tumor ranged from 2.5 to 11.0 cm, with an average of (5.8 ± 2.3) cm. Results: All the 15 surgeries were successfully completed and no transfer was made. The mean operative time was (104.6 ± 40.6) min, the mean amount of bleeding during operation was (45.3 ± 20.4) ml, the average time for postoperative recovery was 1.5 ± 0.4 days, and the average length of postoperative hospital stay was (7.2 ± 0.5) days. Surgical complications. All cases were confirmed by postoperative pathology adrenal ganglion cell neuroma. Follow-up 1-96 months, no recurrence of tumor and distant metastasis was found. Conclusion: Adrenal ganglioneuroma is a rare adrenal tumor that can be initially diagnosed by imaging examination. For less than 6cm adrenal ganglioneuroma, retroperitoneal laparoscopic resection is a safe and effective minimally invasive surgical approach. For tumors> 6cm, surgical risk increases, the surgeon’s surgical experience and technical requirements significantly improved.