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目的:观察两种术式治疗较大体积嗜铬细胞瘤的临床疗效。方法:回顾分析自2005年6月~2015年1月就诊于安徽省立医院同期行手术治疗的嗜铬细胞瘤患者64例,肿瘤直径≥5cm且术后病理证实为嗜铬细胞瘤,其中开放手术患者34例,后腹腔镜手术患者30例,收集两组患者性别、年龄、病程时间、手术时间、肿瘤最大直径、术中出血量、术中输血例数、术中血压波动(>基础血压30%)例数、术后胃肠功能恢复时间、术后拔管时间、SIRS例数、术后住院时间等临床指标进行统计学分析。结果:所有患者均成功完成手术,术后病理均证实为嗜铬细胞瘤,统计学比较显示,开放组和后腹腔镜组在性别、年龄、肿瘤位置、肿瘤直径、病程时间、术中血压波动例数,手术时间差异均无统计学意义(P>0.05),开放组和后腹腔镜组在术中输血例数、术后发生SIRS例数、术后胃肠功能恢复时间、术后拔除引流管时间、术后住院时间差异均有统计学意义(P<0.05)。结论:在充分的术前准备情况下,后腹腔镜治疗较大体积嗜铬细胞瘤具有出血少、创伤小、术后恢复快、住院时间短、并发症少等优点,并且与开放手术相比并不会增加术中血压波动。远期随访结果与开放手术相当,临床应用是安全可靠的。
Objective: To observe the clinical efficacy of two kinds of surgical treatment of larger volume pheochromocytoma. Methods: A retrospective analysis of 64 cases of pheochromocytoma treated surgically in Anhui Provincial Hospital from June 2005 to January 2015 was performed. The diameter of the tumor was ≥5 cm and the pathology was confirmed as pheochromocytoma. Among them, 34 patients underwent surgery and 30 patients underwent retroperitoneal laparoscopic surgery.The gender, age, duration of disease, operation time, maximum tumor diameter, intraoperative blood loss, intraoperative blood transfusion, intraoperative blood pressure fluctuation (> basal blood pressure 30%) cases, postoperative gastrointestinal function recovery time, postoperative extubation time, SIRS cases, postoperative hospital stay and other clinical indicators for statistical analysis. Results: All the patients were successfully completed the operation, postoperative pathology confirmed as pheochromocytoma, statistical comparison showed that open group and retroperitoneal laparoscopic group in gender, age, tumor location, tumor diameter, duration of disease, intraoperative blood pressure fluctuations There were no significant differences in the number of cases and operation time between the two groups (P> 0.05). The number of blood transfusion, the number of SIRS, the recovery time of postoperative gastrointestinal function, the number of postoperative drainage and drainage Tube time, postoperative hospital stay differences were statistically significant (P <0.05). Conclusions: Retroperitoneal laparoscopic treatment of large-volume pheochromocytoma has the advantages of less bleeding, less trauma, faster postoperative recovery, shorter hospital stay, fewer complications, and the like compared with open surgery under adequate preoperative preparation. Does not increase intraoperative blood pressure fluctuations. Long-term follow-up results are equivalent to open surgery, clinical application is safe and reliable.