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目的:探讨腹腔镜手术切除巨大(直径≥8 cm)肾上腺肿瘤的可行性。方法:采用经腹途径腹腔镜切除术治疗巨大肾上腺肿瘤患者6例,左侧4例,右侧2例,肿瘤最大径8.5～12 cm。结果:6例腹腔镜手术均获得成功,无中转开放手术。手术时问平均120 min(90～185 min),术中出血量平均150 ml(50～400 m1)。术后胃肠功能恢复时间1～2天,术后2～3天拔除引流管,术后住院6～10天。随访4～24个月,未发现异常。病理检查报告肾上腺嗜铬细胞瘤2例,神经节细胞瘤1例,神经鞘瘤1例,髓性脂肪瘤2例。结论:肿瘤大小并不是选择腹腔镜手术的决定性因素。在技术娴熟的条件下,腹腔镜治疗巨大肾上腺肿瘤是安全、可行的。
Objective: To investigate the feasibility of laparoscopic resection of huge (≥8 cm in diameter) adrenal tumors. Methods: 6 cases of giant adrenal tumors were treated by laparoscopic transabdominal approach, 4 on the left and 2 on the right, with a maximum diameter of 8.5 to 12 cm. Results: 6 cases of laparoscopic surgery were successful, no transit open surgery. Surgery, mean 120 min (90 ~ 185 min), intraoperative blood loss average 150 ml (50 ~ 400 m1). Postoperative gastrointestinal function recovery time of 1 to 2 days, 2 to 3 days after removal of the drainage tube, postoperative hospital 6 to 10 days. Follow-up 4 to 24 months, no abnormalities were found. 2 cases of adrenal pheochromocytoma, 1 case of ganglioneuroma, 1 case of schwannoma and 2 cases of myelolipoma. Conclusion: Tumor size is not a decisive factor in the choice of laparoscopic surgery. Laparoscopic treatment of giant adrenal tumors is safe and feasible under technically competent conditions.