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目的:总结解放军总医院泌尿外科经后腹腔途径机器人辅助腹腔镜巨大嗜铬细胞瘤切除术的临床经验。方法:回顾性分析2014年1月~2016年2月间应用达芬奇机器人实施的25例经后腹腔途径机器人辅助腹腔镜巨大嗜铬细胞瘤切除术的临床资料。结果:25例手术均获得成功,无副损伤及中转开放,肿瘤位于左侧16例,右侧9例;肿瘤直径6.5~12.0cm,平均(8.43±1.31)cm;其中肾上腺嗜铬细胞瘤25例;手术时间40~100min,平均(69.9±16.7)min;术中出血量50~400ml,平均(138.0±79.4)ml,术中均未输血;其中5例未留置引流管;术后住院3~6d,平均5d。2例失访,余23获得随访6~30个月,随访期内无肿瘤复发。结论:应用机器人辅助腹腔镜技术行后腹腔途径的巨大肾上腺肿瘤切除是安全有效的手术方法,具有术中创伤小、出血少、高清成像视野清晰、机械手臂操作精细、后腹腔途径对腹部脏器的干扰小、术后恢复快等特点,是巨大肾上腺肿瘤手术的较好选择。
OBJECTIVE: To summarize the clinical experience of robotic laparoscopic huge pheochromocytoma resection by Department of Urology, PLA General Hospital. Methods: The clinical data of 25 cases of giant pheochromocytoma excised by laparoscopic robot assisted by Da Vinci robot from January 2014 to February 2016 were analyzed retrospectively. Results: Twenty-five surgeries were successfully performed with no side-effects and no metastasis. The tumors were located on the left side in 16 cases and the right side in 9 cases. The diameter of tumors was 6.5-12.0 cm (mean, 8.43 ± 1.31 cm). Among them, adrenal pheochromocytoma The mean operative time was 40 to 100 minutes (mean, 69.9 ± 16.7) min. The intraoperative blood loss was 50 to 400 ml (mean, 138.0 ± 79.4) ml. No blood transfusion was given during operation. ~ 6d, an average of 5d. Two patients were lost to follow-up, and 23 patients were followed up for 6 to 30 months. No tumor recurrence was observed during the follow-up period. Conclusion: The huge abdominal adrenal tumor resection using robotic laparoscopic approach is a safe and effective surgical approach. It has the advantages of less intraoperative trauma, less bleeding, clear high-definition imaging vision, fine mechanical arm operation, and post-abdominal approach to abdominal organs Small interference, fast recovery and other characteristics, is a good choice for huge adrenal tumor surgery.