后腹腔镜治疗肾上腺髓性脂肪瘤(附11例报告)

摘要

目的 探讨后腹腔镜治疗肾上腺髓性脂肪瘤的手术治疗经验和临床疗效.方法 11例肾上腺髓性脂肪瘤患者,其中男6例,女5例;年龄23～63岁;左侧4例,右侧7例;术前均经超声、CT和CT增强扫描等检查确诊,均接受后腹腔镜肾上腺髓性脂肪瘤切除术.结果 本组患者均手术成功;平均手术时间(88±12) min,出血量(65±10) ml,术后住院天数(7±1.5)天;肿瘤最大径4～8.5 cm,平均5.6 cm;术中、术后无并发症出现,术后病理结果证实为肾上腺髓性脂肪瘤;随访6～48个月,未见肿瘤复发.结论 后腹腔镜肾上腺髓性脂肪瘤切除术具有安全、有效、创伤小、疗效确切、并发症少和术后恢复快等优点,是治疗肾上腺髓性脂肪瘤的首选方法.%Objective To investigate the surgical experience and clinical efficacy in treatment of adrenal myelolipoma by retroperitoneoscopic excision. Methods 11 patients (6 males and 5 females, aged 23 - 63) were diagnosed as having adrenal myelolipoma, which was confirmed by ultrasound, CT and CT contrast enhanced scan. The tumor was left - sided in 4 patients and right - sided in 7 patients. All the patients underwent retroperitoneoscopic surgery. Results Retroperitoneoscopic surgery was successfully performed in all the 11 patients, with an average operative duration of (88 ± 12) min, average intraoperative blood loss of (65 ± 10) ml and average postoperative hospital stay of (7 ± 1.5) days.The maximal tumor size was 4 - 8.5 cm ( mean = 5.6). No apparent intraoperative and postoperative complications occurred in our study. Postoperative pathological reports confirmed adrenal myelolipoma. Follow - ups of 6 - 48 months showed good results, with no recurrence. Conclusion Retroperitoneoscopic excision of adrenal myelolipoma has the advantage of safety, feasibility, minimal invasion, confirmed effectiveness, fewer complications and rapid recovery. The procedure should be the optimal option in the treatment of adrenal myelolipoma.