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目的:探讨脐部单切口三孔腹腔镜肾上腺全切手术可行性及初步治疗经验。方法:4例患者,男2例,女2例,平均35(32～45)岁。左侧3例,右侧1例。根据脐部形状在脐部作3.0 cm左右的切口,插入二根10mm套管和一根5 mm套管作为窥视孔及操作孔,腹腔镜下常规操作,完成肾上腺全切手术。手术操作通过腹腔镜器械及超声刀完成。肾上腺中央静脉用Hem-o-lok结扎并切断,标本放入标本袋后经切口取出。结果:平均手术时间90(70～151)min,术中出血量平均100(90～150)ml,术后平均排气时间8(6～12)h。平均住院时间7(6～9)天,术后4例随访平均3个月。脐部切口愈合好,腹部无可见瘢痕,无脐疝及肠梗阻等并发症。结论:经脐单孔腹腔镜下肾上腺全切除术安全可行,脐部切口美观,具有较好的微创效果,远期的临床效果需要进一步观察。
Objective: To investigate the feasibility and initial treatment experience of single incision three-hole laparoscopic adrenalectomy at umbilicus. Methods: Four patients, 2 males and 2 females, average 35 (32-45) years old. Left in 3 cases, right in 1 case. According to the umbilicus shape in the navel for about 3.0 cm incision, insert two 10mm cannula and a 5mm cannula as a peephole and operation hole, laparoscopic routine operation, complete adrenalectomy. Surgical operation by laparoscopic instruments and ultrasound knife to complete. The central adrenal vein with Hem-o-lok ligation and cut off, the specimen into the specimen bag removed after incision. Results: The average operative time was 90 (70-151) min. The mean intraoperative blood loss was 100 (90-150) ml and the average postoperative exhaust time was 8 (6-12) h. The average length of hospital stay was 7 (6 ~ 9) days, and the average follow-up of 4 patients was 3 months. Umbilical incision healed well, no visible scar on the abdomen, no umbilical hernia and intestinal obstruction and other complications. Conclusion: The transabdominal single-hole laparoscopic adrenalectomy is safe and feasible, the umbilical incision is beautiful and has good minimally invasive effect. The long-term clinical effect needs further observation.