目的 探讨肾上腺肿瘤手术中保留正常肾上腺的安全性及应用价值.方法 回顾性分析2006年1月至2016年12月于我科接受保留肾上腺组织的肾上腺手术治疗的97例肾上腺肿瘤患者的临床资料,肿瘤位于左侧50例、右侧32例、双侧15例,肿瘤平均直径2.3(0.9~4.6)cm,97例中醛固酮腺瘤58例、Cushing综合征12例、嗜铬细胞瘤5例、无功能腺瘤22例.结果 所有患者手术均成功,手术时间平均71min;术中失血量平均36ml;术后住院天数平均4.2d.随访3~48个月,患者临床症状消失,残存肾上腺组织功能良好,均不需要激素替代治疗.结论 对于体积较小的肾上腺肿瘤患者,施行肾上腺肿瘤切除手术时保留正常肾上腺组织,安全性高,疗效良好,可避免患者术后需长期激素替代治疗而带来的危害,值得临床推广.%Objective To evaluate the safety and application value of retaining normal adrenal gland in surgery of adrenal tumors. Methods The retrospective analysis was made on the clinical data of 97 patients who underwent retroperitoneal laparoscopic adrenal-sparing surgery from Jan. 2006 to Dec.2016.The mean size of the adrenal tumours was 2.3 (range,0.9-4.6)cm,and was on the left side in 50 cases,the right side in 32,and bilateral tumors in 15.Primary hyperaldosteronism was found in 58 cases,Cushing's syndrome was found in 12 cases,phaeochromocytoma was found in 5 cases,and nonfunctional adenoma was found in 22 cases. Results All the patients underwent the operation successfully.The mean operative time was 7 1 minutes.The mean blood loss was 3 6 ml. The mean postoperative hospital stay was 4.2 days.Over the follow-up period of 3-48 months,pa-tients'clinical symptoms all disappeared,the functions of remaining adrenal glands were good,and no patient required steroid replacement. Conclusions Adrenal-sparing procedure in adrenalectomy for small adrenal tumor is safe,effective and feasible.The function of remaining adrenal gland can be reserved to avoid the danger of long-term steroid replacement.
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