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首页> 外文期刊>Surgical Endoscopy >Laparoscopic vs open adrenalectomy for benign adrenal neoplasm.
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Laparoscopic vs open adrenalectomy for benign adrenal neoplasm.

机译：腹腔镜与开放式肾上腺切除术治疗良性肾上腺肿瘤。

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BACKGROUND: The aim of this study was to compare the outcome of laparoscopic adrenalectomy (LA) performed for benign adrenal neoplasm to the open procedure in a similar group of patients. METHODS: All consecutive patients who underwent LA between June 1996 and February 1999 were evaluated. Data analysis included patient's age and gender, indication for surgery, histological diagnosis, size of specimen, comorbid conditions, length of stay and ileus, postoperative narcotic consumption, and time to return to normal activity. The results were compared retrospectively to a well-matched group of patients who underwent an open adrenalectomy (OA). RESULTS: Twenty-eight LA were performed in 24 patients for the following disorders: adrenocortical adenoma, 16 (four Cushing's syndrome, 12 Conn's syndrome); pheochromocytoma, 10; and nonfunctioning tumor, two. These cases were compared with a well-matched group of 28 patients who underwent OA in the same department. There were two conversions to open surgery (7%) in the laparoscopic group and no deaths in either group. Of all the evaluated parameters, the following statistically significant differences between the two groups were noted: The mean operative time was longer in the LA group (188 vs 139 min, p < 0.001.); however, this became insignificant in the last 10 cases of LA, when the mean length of surgery was reduced to 130 min. The overall morbidity was lower in the LA group (16% vs 39%, p = 0.05), as was the mean time to tolerate a regular diet (2 vs 3.9 days), mean meperidine consumption (mg) (109 vs 209), mean length of stay (4 vs 7.5 days), and mean time to return to normal activity (2.2 vs 5.2 weeks), (p < 0.001 for all). CONCLUSION: LA for benign adrenal disorders is a safe procedure that is associated with significantly lower morbidity, shorter ileus and hospitalization, reduced postoperative pain, and a faster return to normal activity than the open procedure.
机译：背景：这项研究的目的是比较在类似的患者组中，针对良性肾上腺肿瘤进行的腹腔镜肾上腺切除术（LA）与开放手术的结果。方法：对1996年6月至1999年2月期间接受LA的所有连续患者进行评估。数据分析包括患者的年龄和性别，手术指征，组织学诊断，标本大小，合并症，住院时间和回肠时间，术后麻醉剂消耗以及恢复正常活动的时间。回顾性地将结果与接受了开放性肾上腺切除术（OA）的一组患者完全匹配。结果：24例患者因以下疾病进行了28次LA：肾上腺皮质腺瘤16例（库欣综合征4例，康氏综合征12例）。嗜铬细胞瘤，10;和无功能的肿瘤，两个。将这些病例与在同一部门接受OA的一组匹配良好的28例患者进行比较。腹腔镜手术组有两次转换为开腹手术（7％），两组均无死亡。在所有评估的参数中，两组之间存在以下统计学上的显着差异：LA组的平均手术时间更长（188比139分钟，p <0.001）。但是，在LA的最后10例中，当平均手术时间减少到130分钟时，这变得无关紧要。 LA组的总发病率较低（16％vs 39％，p = 0.05），耐受常规饮食的平均时间（2 vs 3.9天），平均哌替啶摄入量（mg）（109 vs 209），平均住院时间（4天与7.5天），以及恢复正常活动的平均时间（2.2天与5.2周），（所有患者的P <0.001）。结论：对于良性肾上腺疾病，LA是一种安全的手术，与开放手术相比，其发病率显着降低，肠梗阻和住院时间缩短，术后疼痛减轻，恢复正常活动的速度更快。

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