摘要
目的比较经腹腔肠系膜间隙入路与结肠旁沟入路腹腔镜肾上腺肿瘤切除术治疗左侧原发性醛固酮增多症(PHA)的疗效。方法回顾性分析兰州大学第一医院及甘肃省其他5家医院2017年1月至2019年7月70例手术治疗左侧PHA患者的临床资料。患者包括男43例、女27例;28例行经腹腔肠系膜间隙入路腹腔镜肾上腺肿瘤切除术,42例行经腹腔结肠旁沟入路腹腔镜肾上腺肿瘤切除术,比较两组患者的一般资料和围手术期结果。结果70例患者手术全部成功完成,肠系膜间隙入路组手术时间短于结肠旁沟入路组[(26.7±8.8)比(38.9±7.1)min,P<0.001)],失血量少于结肠旁沟入路组[45(30,50)比50(40,60)ml,P=0.042],术后住院时间两组间差异无统计学意义[(4.4±1.0)比(4.5±1.0)d,P=0.669)]。术后1个月复查,患者电解质及醛固酮肾素比值均正常,53例(75.7%)患者血压基本恢复正常。结论经腹腔肠系膜间隙入路腹腔镜肾上腺肿瘤切除术安全可行,手术时间短,失血量少。
Objective To compare the therapeutic effect of transperitoneal transmesenteric approach versus paracolic sulci approach laparoscopic adrenal tumorectomy for treatment of left-sided primary hyperaldosteronism.Methods From January 2017 to July 2019,the clinical data of 70 patients with left-sided primary hyperaldosteronism(PHA)who underwent surgery in the First Hospital of Lanzhou University and five other hospitals in Gansu Province were retrospectively analyzed.There are 43 male and 27 female patients.Among them,28 patients were performed transperitoneal transmesenteric approach laparoscopic adrenal tumorectomy and 42 patients were performed transperitoneal paracolic sulci approach laparoscopic adrenal tumorectomy.The general information and perioperative data of the two groups were compared.Results All 70 cases of surgery were successfully completed.As compared with the paracolic sulci approach group,the operation time was significantly shorter in the transmesenteric approach group[(26.7±8.8)vs(38.9±7.1)min,P<0.001)],and the estimated blood loss was less in the transmesenteric approach group[45(30,50)vs 50(40,60)ml,P=0.042].There was no statistically significant difference in the postoperative hospitalization days between the two groups[(4.4±1.0)vs(4.5±1.0)d,P=0.669)].The electrolytes and aldosterone to renin ratio returned to a healthy level in the postoperative one month,and the blood pressure also returned to a healthy level in 53(75.7%)patients.Conclusion Transperitoneal transmesenteric approach laparoscopic adrenal tumorectomy is safe and feasible,with a short operation time and relatively less estimated blood loss.
作者
张立元
郑铎
景锁世
张小康
常鹏程
杨捷
裴建强
杜宏纲
宋峻岩
秦萌贤
党治军
王治安
柴克强
Zhang Liyuan;Zheng Duo;Jing Suoshi;Zhang Xiaokang;Chang Pengcheng;Yang Jie;Pei Jianqiang;Du Honggang;Song Junyan;Qin Mengxian;Dang Zhijun;Wang zhi'an;Chai Keqiang(Department of Urology No.2,the First Hospital of Lanzhou University,Lanzhou 730030,China;Department of Urology,Jiu Gang Hospital,Jiayuguan 735100,China;Department of Urology,Jinchuan Group Staff Hospital,Jinchang 737100,China;Department of Urology,Yumen First People′s Hospital,Yumen 735211,China;Department of Urology,Jiuquan Second People′s Hospital,Jiuquan 735000,China;Department of Urology,Baiyin First People′s Hospital,Baiyin 730900,China)
出处
《中华医学杂志》
CAS
CSCD
北大核心
2021年第20期1513-1517,共5页
National Medical Journal of China
基金
兰州市科技计划项目(2012-1-27)
兰州市人才创新创业项目(2014-RC-66)。
