Portless endoscopic adrenalectomy via a single minimal incision using a retroperitoneal approach: Experience with initial 30 cases
Portless endoscopic adrenalectomy via a single minimal incision using a retroperitoneal approach: Experience with initial 30 cases
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DOI：
10.1111/j.1442-2042.2004.00897.x
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发表时间：
2004-09-01
影响因子：
2.6
通讯作者：
Hyochi, N
中科院分区：
文献类型：
--
作者：
Kageyama, Y;Kihara, K;Hyochi, N
目的：评估通过单个最小切口狭窄地提取标本的无端口内窥镜肾上腺切除术的可行性。方法：对30例肾上腺肿瘤，采用单侧切口（3- 9cm，平均5.6 cm）行无孔内窥镜手术，不充气，不放置套管针。手术中使用的所有器械均可重复使用。包括原发性醛固酮增多症12例，库欣综合征6例，临床前库欣综合征3例，嗜铬细胞瘤1例，无功能皮质腺瘤6例，肾上腺皮质癌1例，肾上腺皮质出血1例。结果：所有病例均成功切除肿瘤，无并发症。手术时间83 ~ 240 min（平均147 min）。估计失血量为5-470 mL（平均139 mL）。没有一个病人需要输血。术后过程顺利。大多数病例伤口疼痛轻微，术后第一天和第二天分别恢复行走和全口喂养。结论：肾上腺肿瘤具有安全、经济、微创、与腹腔镜手术相匹配的优点，是开展无孔内窥镜手术的理想选择。
Aim: To assess the feasibility of portless endoscopic adrenalectomy via a single minimum incision that narrowly permits extraction of the specimen.Methods: For 30 cases of adrenal tumor, portless endoscopic surgery through a single flank incision (3-9 cm; mean, 5.6 cm) was performed without gas inflation or trocar port placement. All of the instruments used during surgery were reusable. The cases included primary aldosteronism (12), Cushing's syndrome (6), preclinical Cushing's syndrome (3), pheochromocytoma (1), non-functioning cortical adenoma (6), adrenocortical carcinoma (1) and adrenocortical hemorrhage (1).Results: Resection of the tumor was successfully completed, without complications, in all of the cases. Operative time was between 83 and 240 min (mean, 147 min). Estimated blood loss was 5-470 mL (mean, 139 mL). None of the patients required blood transfusion. Postoperative course was uneventful. Wound pain was mild and walking and full oral feeding were resumed on the first and second postoperative day, respectively, in the majority of cases.Conclusions: Adrenal tumors are good candidates for portless endoscopic surgery, which is safe, cost-effective, minimally invasive and matches favorably with laparoscopic surgery.