The efficacy and safety of posterior retroperitoneoscopic adrenalectomy in the prone position / 中华泌尿外科杂志

Objective:To explore the efficacy and safety of posterior retroperitoneoscopic adrenalectomy (PRA) in the prone position.Methods:The clinical data of 74 patients who underwent PRA in the prone position in our hospital from January 2019 to February 2021 were reviewed. There were 36 males and 38 females, with an average age was (54.4±12.5) years old. The body mass index was (24.03±3.5) kg/m 2. CT scans of the adrenal glands were performed before operation. There were 39 cases of adrenal tumors on the left side, 33 cases on the right side, and 2 cases on both sides. The diameter of adrenal tumors shown on CT was (2.4±1.3) cm. Among them, 22 cases were diagnosed of non-functional adrenal tumors, 21 cases were primary aldosteronism, 8 cases were Cushing syndrome, and 23 cases were pheochromocytoma . The PRA in the prone position were performed in all 74 patients(76 sides). Results:The operation was performed successfully in all 74 patients(76 sides), of which 42 cases underwent unilateral adrenalectomy, 30 cases underwent unilateral partial adrenalectomy and 2 cases underwent bilateral adrenalectomy. The operation time was (53.2±16.1) min for 76 sides, and the time of two bilateral cases was 70 min and 115 min respectively. The median time of rainage tube indwelling was 3(0, 4) d, and the hospital stay was (4.2±0.9) d. The pathological diagnosis: there were 32 cases of adrenal cortical adenoma, 8 cases of adrenal cortical hyperplasia nodule, 5 cases of adrenal cyst, 7 cases of adrenal medullary lipoma, and 22 cases of adrenal pheochromocytoma. No adverse complications occurred during the perioperative period. The patients were followed-up for (12.5±2.7) months, and no tumor recurrence or long-term complications occurred.Conclusions:Posterior retroperitoneoscopic adrenalectomy in the prone position has the advantages of reducing bleeding and exudation, and rapid recovery after surgery, which provides a safe and effective surgical method for the treatment of adrenal tumors.

Clinical application progress of minimally invasive percutaneous nephrolithotomy / 国际外科学杂志

Percutaneous nephrolithotomy is one of the common surgical modalities for the treatment of upper urinary calculi. In recent years, with the continuous development and improvement of endoscopic technology, laser technology and negative pressure suction technology, stone free rate of minimally invasive percutaneous nephrolithotomy is improved and the operation time is shortened, making the patient trauma smaller, comfort increased and hospitalization time shortened. This positive surgical effect and reliable safety have enabled minimally invasive percutaneous nephrolithotomy to develop rapidly and become widely used in the clinic. In this paper, the application and progress of minimally invasive percutaneous nephrolithotomy in the clinic are reviewed, with a view to providing a reference basis and clinical guidance for future clinical treatment.