Retroperitoneal laparoscopic adrenalectomy :36 cases / 中华内分泌外科杂志

ABSTRACT

Objective To evaluate the value of retroperitoneal laparoscopic adrenalectomy for benign adrenal tumors.Methods From Mar.2009 to Oct.2011,36 patients with adrenal tumors received retroperitoneal laparoscopic adrenalectomy in the First People's Hospital of Shangqiu.During the operation,3 trocars were introduced into the lumbar region to establish retroperitoneal space.Afterwards,the tumor was removed by using a harmonic scalpel.Results The procedures were successfully completed in 19 cases of adrenocortical adenoma,14 cases of pheochromocytoma,2 cases of adrenal cyst and 1case of adrenocortical carcinoma without blood transfusion.The median operation time was 90 min,ranging from 45 min to 180 min.The median intraoperative blood loss was 76 ml,ranging from 30 ml to 700 ml.Drainage tubes were removed 2 days after the operation and the patients were discharged from hospital 3 to 5 days after operation.2 cases were converted to open surgery ( one because of the adhesion between the tumor and vena cava,the other because of the size (about 6.0 cm) of the tumor).The median follow-up time was 12 months,ranging from 3 to 24 months.One patient showed regional subcutaneous emphysema after the surgery and was cured spontaneously.The patients were followed up for 3 to 24 months with the medium of 12 months.Normal blood pressure was achieved in 30 patients in 3 months,while oral antihypertension drugs were still needed for the other 6 patients (2 patients converted to open surgery included).No regional recurrence or death happened during the follow-up.Conclusion Retroperitoneal laparoscopic adrenalectomy can be a safe and effective choice for adrenal tumors,with advantages of small trama,quick recovery,short postoperative hospital stay etc.