目的 探讨手辅助腹腔镜肾上腺切除术治疗巨大肾上腺肿瘤的手术方法和效果.方法 2004年7月～2009年3月,采用经腹腔入路手辅助腹腔镜肾上腺切除术治疗直径大于6锄的巨大肾上腺肿瘤患者16例.观察手术时间,术中出血量和术后并发症及手术效果.结果 16例手术均获成功,无中转为开放手术.手术时间41～115 min,平均84min.术中出血量15～450 mL,平均105 mL.术后住院时间5～8 d,平均6.9 d.术中和术后未出现明显并发症.术后病理:嗜铬细胞瘤13例,嗜酸细胞瘤1例,皮质癌1例,节细胞神经母细胞瘤1例.术后随访6～24个月,平均15个月,术后6个月内血压均恢复正常,无明显不适.结论 对于直径大于6cm的巨大肾上腺肿瘤,可选择手辅助腹腔镜肾上腺切除术.具有手术时间短,视野清晰,创伤小,出血少、恢复快等特点,可以进一步缩短手术时间,降低手术的风险.%[Objective] To evaluate the operation method and effect of transpefitoneal Hand-assisted laparoscopie adrenalectomy of giant adrenal tumor. [Methods] From July 2004 to March 2009, 16 patients, 10 male and 6 female, aged from 24 to 76 years, received hand-assisted laparoscopic adrenalectomy. The diameters of the adrenal tumors were 6.5～13.5 cm, the mean operation time, estimated blood loss and complications were used to evaluate the effect of operation. [Results] All the 16 hand-assisted patients with transperitoneal laparoscopic adrenalectomy were successful and no open conversions. The mean operation time was (84±15) min and the estimated blood loss was 15～450 mL with a mean of (55±25) mL. The patients could get down in 24h after operation. The postoperative hospital stay was 5～8 days with a mean of (7±1) days. No serious complications occurred during operation and postoperation. [ Conclusion ] To compare with open surgery and laparoscopic adrenalectomy, hand-assisted laparoscopic adrenalectomy is safe and feasible for giant adrenal tumors.
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