• 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>Surgical Endoscopy >Endoscopic adrenalectomy for pheochromocytoma: difference between the transperitoneal and retroperitoneal approaches in terms of the operative course.
【24h】

Endoscopic adrenalectomy for pheochromocytoma: difference between the transperitoneal and retroperitoneal approaches in terms of the operative course.

机译：内窥镜肾上腺切除术治疗嗜铬细胞瘤：经腹膜后和腹膜后入路在手术过程方面的差异。

获取原文
获取原文并翻译 | 示例
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

BACKGROUND: Due to the intraoperative catecholamine secretion with hemodynamic changes, a larger tumor size and marked neovascularization, as compared with other adrenal pathologies, endoscopic adrenalectomy for pheochromocytoma represents a particular challenge involving a more difficult and morbid procedure. The aim of this study was to identify the optimal surgical approach for endoscopic adrenalectomy in patients with pheochromocytoma. METHODS: Over a period of 10 years (February 1994 to June 2004), 38 consecutive patients underwent endoscopic adrenalectomy for pheochromocytoma. As three patients underwent a bilateral procedure, a total of 41 adrenalectomies were performed. The transperitoneal approach was carried out in 23 patients, whereas 18 patients underwent a retroperitoneal adrenalectomy by a single operative team. Perioperative parameters were prospectively followed. RESULTS: There was no conversion to the open procedure. Intraoperative hypertensive episodes occurred in 21 patients (55.3%) and were controlled by antihypertensive agents. In 11 patients (28.9%), blood pressure values rose to above 200 mmHg (> 1 min). A comparison between the retroperitoneal and transperitoneal procedures did not show a significant difference between the maximum intraoperative systolic (p = 0.730) and diastolic (p = 0.663) blood pressure values although intraoperative blood pressure peaks were seen more frequently during retroperitoneal adrenalectomy. The operative time was shorter for the patients who had transperitoneal adrenalectomy than compared to for those who had retroperitoneal adrenalectomy, although the difference was not significant. The intraoperative blood loss, perioperative morbidity, and length of postoperative hospital stay did not differ significantly between the surgical techniques (p > 0.05). CONCLUSION: After adequate preparation, endoscopic adrenalectomy may be performed in patients with pheochromocytoma via both the retroperitoneal and the transperitoneal approaches. The shorter operating time, less frequent intraoperative blood pressure peaks, and the better overview of the operating field recommend the transperitoneal approach with the patient placed in a lateral position as the preferred operative procedure.
机译：背景：由于术中儿茶酚胺的分泌具有血流动力学变化，较大的肿瘤大小和明显的新生血管形成，与其他肾上腺病理学相比，内镜下肾上腺肾切除术治疗嗜铬细胞瘤是一项特别的挑战，涉及更困难和病态的手术。这项研究的目的是确定嗜铬细胞瘤患者内镜肾上腺切除术的最佳手术方法。方法：在10年期间（1994年2月至2004年6月），连续38例患者接受了内镜下肾上腺切除术治疗嗜铬细胞瘤。当三名患者接受双侧手术时，总共进行了41次肾上腺切除术。经腹膜入路治疗的有23例患者，而18例由一个手术团队进行了腹膜后肾上腺切除术。围手术期参数前瞻性。结果：没有转换为打开过程。术中高血压发作发生在21例患者中（55.3％），并由降压药控制。在11名患者中（28.9％），血压值上升到200 mmHg以上（> 1分钟）。腹膜后和经腹膜手术之间的比较没有显示术中最大收缩压（p = 0.730）和舒张压（p = 0.663）之间的显着差异，尽管腹膜后肾上腺切除术中术中血压峰值更为频繁。经腹膜肾上腺切除术的患者比经腹膜后肾上腺切除术的患者的手术时间短，尽管差异不显着。两种手术方法之间的术中失血量，围手术期发病率和术后住院时间无明显差异（p> 0.05）。结论：充分准备后，可通过腹膜后和经腹膜途径对嗜铬细胞瘤患者进行内镜肾上腺切除术。手术时间越短，术中血压峰值的发生频率越低以及对手术视野的了解越好，建议将患者侧卧放置经腹膜后入路作为首选手术方法。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号