Comparison of retroperitoneal laparoscopic versus open adrenalectomy for large pheochromocytoma: a single-center retrospective study
Comparison of retroperitoneal laparoscopic versus open adrenalectomy for large pheochromocytoma: a single-center retrospective study
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后腹腔镜与开腹肾上腺切除术治疗大型嗜铬细胞瘤的比较：单中心回顾性研究
DOI：
10.1186/s12957-019-1649-x
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发表时间：
2019-06-29
影响因子：
3.2
通讯作者：
Yang, Weimin
中科院分区：
文献类型：
--
作者：
Zhu, Wei;Wang, Shaogang;Yang, Weimin
背景后腹腔镜肾上腺切除术（RLA）治疗大型嗜铬细胞瘤（PHEO）是否安全有效尚不清楚。本回顾性研究旨在确定RLA的优点和缺点相比，开放肾上腺切除术（OA）MethodsThis study included 147例患者接受RLA（n=101）或OA（n=46）PHEO大于5cm。通过倾向评分匹配（PSM）将各组平衡为46对。两组之间的围手术期变量和长期随访结果进行了比较。结果PSM后，患者在RLA组有较短的手术时间（218与245分钟，P=0.040），更快的肠道恢复（2与3d，P=0.046），和较短的住院时间（8与9d，P=0.010）相比，OA组。多元线性回归分析结果显示，手术方法（OA与RLA）对上述三个术后变量有影响（分别为=31.84，P=0.046; =0.76，P=0.044;=1.25，P=0.025）。两组血压改善的患者比例（82. 61% vs. 69.57%，P=0.143）无显著差异。结论RLA和OA为大型PHEO的手术治疗提供了相似的围手术期和长期结局。对于直径大于5cm的PHEO患者，RLA是一种有效且安全的手术方法。
BackgroundIt remains unclear whether retroperitoneal laparoscopic adrenalectomy (RLA) is safe and effective for the treatment of large pheochromocytoma (PHEO). This retrospective study aimed to identify the advantages and disadvantages of RLA compared to open adrenalectomy (OA).MethodsThis study included 147 patients who underwent RLA (n=101) or OA (n=46) for PHEO larger than 5cm. Groups were balanced by propensity score matching (PSM) into 46 pairs. Perioperative variables and long-term follow-up results were compared between the two groups.ResultsAfter PSM, patients in the RLA group had a shorter operative time (218 vs. 245min, P=0.040), quicker bowel recovery (2 vs. 3days, P=0.046), and a shorter hospital stay (8 vs. 9days, P=0.010) compared to the OA group. The results of multiple linear regression analyses showed that the operative method (OA vs. RLA) had an influence on the above three postoperative variables (=31.84, P=0.046; =0.76, P=0.044; and =1.25, P=0.025, respectively). There was no significant difference in the proportion of patients with improved blood pressure (82.61% vs. 69.57%, P=0.143) between the two groups.ConclusionsBoth RLA and OA provide similar perioperative and long-term outcomes for the surgical management of large PHEO. RLA is an efficacious and safe surgical method for patients with PHEO larger than 5cm in diameter.