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目的 :应用后腹腔镜手术治疗肾上腺疾病并评价其临床价值。方法 :2 0 0 1年 9月～ 2 0 0 2年 11月间 ,采用后腹腔镜手术治疗各类肾上腺疾病 2 1例 ,包括 11例原发性醛固酮增多症、4例无功能性腺瘤、3例皮质醇增多症、2例骨髓脂肪瘤和 1例嗜铬细胞瘤。病变位于左侧 14例 ,右侧 7例。全部病例均采用腹膜后径路。结果 :2 1例手术均获成功。前 10例手术时间 110～ 2 3 0min ,平均 167min ;后 11例手术时间 45～ 2 2 0min ,平均114min。术中出血 10～ 80ml,平均 2 18ml,未输血。术后平均住院日 5.8d。无 1例出现膈肌损伤、切口感染等并发症。结论 :后腹腔镜手术具有损伤小、切口美观、胃肠干扰少、恢复快和住院时间短等优点 ,可作为肾上腺疾病的首选治疗方法
Objective: To evaluate the clinical value of retroperitoneal laparoscopic surgery for adrenal diseases. Methods: From September 2001 to November 2002, 21 cases of various types of adrenal diseases were treated with retroperitoneal laparoscopic surgery, including 11 cases of primary aldosteronism, 4 cases of non-functioning adenoma, 3 cases of Cushing’s disease, 2 cases of myeloma and 1 case of pheochromocytoma. Lesions in the left side of 14 cases, right side in 7 cases. All cases were treated with retroperitoneal approach. Results: All the 21 cases were successful. The first 10 cases of operation time 110 ~ 230min, an average of 167min; after 11 cases of operation time 45 ~ 220min, an average of 114min. Intraoperative bleeding 10 ~ 80ml, an average of 2 18ml, no blood transfusion. The average postoperative hospital stay 5.8d. No case of diaphragmatic injury, incision infection and other complications. Conclusion: Retroperitoneal laparoscopic surgery has the advantages of small injury, beautiful incision, less gastrointestinal interference, quick recovery and shorter hospital stay, which can be used as the first choice of treatment for adrenal diseases