不同入路腹腔镜肾上腺切除术治疗肾上腺肿瘤患者的临床研究
【摘要】 目的 探討经腹膜后入路腹腔镜肾上腺切除术(RLA)、经腹腔入路腹腔镜肾上腺切除术(TLA)治疗肾上腺肿瘤患者的临床疗效。方法 68 例肾上腺肿瘤患者， 采用随机数字表法分为TLA组及RLA组， 各34例。TLA组患者经腹腔入路行腹腔镜肾上腺切除术治疗， RLA组患者经腹膜后入路行腹腔镜肾上腺切除术治疗， 比较两组患者手术时间、术中出血量、恢复进食时间、住院时间、手术前后免疫指标及并发症发生情况。结果 TLA组患者手术时间、术中出血量、恢复进食时间、住院时间分别为(120.11±4.3)min、(67.7±8.9)ml、(23.5±7.6)h、(9.6±1.2)d， RLA组患者手术时间、术中出血量、恢复进食时间、住院时间分别为(87.91±0.7)min、(54.5±7.0)ml、(16.2±5.5)h、(7.5±0.8)d， 比较差异有统计学意义(P<0.05)。手术前， 两组患者免疫球蛋白A(IgA)、免疫球蛋白G(IgG)、免疫球蛋白M(IgM)水平比较， 差异无统计学意义(P>0.05)。手术后， 两组患者IgA、IgM水平比较， 差异无统计学意义(P>0.05);RLA组患者IgG水平明显高于TLA组， 差异具有统计学意义(P<0.05)。RLA组患者并发症发生率为5.9%， 明显低于TLA组的23.5%， 差异具有统计学意义(P<0.05)。结论 在治疗肾上腺肿瘤时采用RLA疗效确切， 可缩短治疗时间， 减少术中出血量， 术后胃肠道功能恢复较快， 降低并发症发生率， 值得在临床治疗中予以借鉴。
【关键词】 腹腔镜;肾上腺切除术;肾上腺肿瘤;临床疗效
DOI：10.14163/j.cnki.11-5547/r.2020.06.009
Clinical study of laparoscopic adrenalectomy with different approaches in the treatment of patients with adrenal tumor GAO Hai-liang. Department of Urology Surgery， Wafangdian Third Hospital， Wafangdian 116300， China
【Abstract】 Objective To discuss the clinical efficacy of retroperitoneal laparoscopic adrenalectomy (RLA) and transperitoneal laparoscopic adrenalectomy (TLA) in the treatment of patients with adrenal tumor. Methods A total of 68 patients with adrenal tumor were divided into TLA group and RLA group by random number table method， with 34 cases in each group. TLA group was treated with laparoscopic adrenalectomy by transperitoneal approach， and RLA group was treated with laparoscopic adrenalectomy by retroperitoneal approach. The operation time， amount of intraoperative hemorrahge， time to resume eating， hospitalization time， immune indexes before and after operation and occurrence of complications were compared between the two groups. Results The operation time， amount of intraoperative hemorrahge， time to resume eating， hospitalization time were (120.1±14.3) min， (67.7±8.9) ml， (23.5±7.6) h and (9.6±1.2) d respectively in TLA group， which were (87.9±10.7) min， (54.5±7.0) ml， (16.2±5.5) h and (7.5±0.8) d respectively in RLA group， and their difference was statistically significant (P<0.05). Before operation， there was no statistically significant difference in levels of immunoglobulin A (IgA)， immunoglobulin G (IgG) and immunoglobulin M (IgM) between the two groups (P>0.05). After operation， there was no statistically significant difference in levels of IgA and IgM between the two groups (P>0.05). The IgG level in RLA group was obviously higher than that in TLA group， and the difference was statistically significant (P<0.05). The incidence of complications was 5.9% in RLA group， which was obviously lower than 23.5% in TLA group， and the difference was statistically significant (P<0.05). Conclusion RLA shows affirmative efficacy for the treatment of adrenal tumor， which can shorten therapeutic time， reduce amount of intraoperative hemorrhage， accelerate the recovery of gastrointestinal function and reduce the incidence of complications. It is worthy of reference in clinical treatment., 百拇医药(高海良)
【关键词】 腹腔镜;肾上腺切除术;肾上腺肿瘤;临床疗效
DOI：10.14163/j.cnki.11-5547/r.2020.06.009
Clinical study of laparoscopic adrenalectomy with different approaches in the treatment of patients with adrenal tumor GAO Hai-liang. Department of Urology Surgery， Wafangdian Third Hospital， Wafangdian 116300， China
【Abstract】 Objective To discuss the clinical efficacy of retroperitoneal laparoscopic adrenalectomy (RLA) and transperitoneal laparoscopic adrenalectomy (TLA) in the treatment of patients with adrenal tumor. Methods A total of 68 patients with adrenal tumor were divided into TLA group and RLA group by random number table method， with 34 cases in each group. TLA group was treated with laparoscopic adrenalectomy by transperitoneal approach， and RLA group was treated with laparoscopic adrenalectomy by retroperitoneal approach. The operation time， amount of intraoperative hemorrahge， time to resume eating， hospitalization time， immune indexes before and after operation and occurrence of complications were compared between the two groups. Results The operation time， amount of intraoperative hemorrahge， time to resume eating， hospitalization time were (120.1±14.3) min， (67.7±8.9) ml， (23.5±7.6) h and (9.6±1.2) d respectively in TLA group， which were (87.9±10.7) min， (54.5±7.0) ml， (16.2±5.5) h and (7.5±0.8) d respectively in RLA group， and their difference was statistically significant (P<0.05). Before operation， there was no statistically significant difference in levels of immunoglobulin A (IgA)， immunoglobulin G (IgG) and immunoglobulin M (IgM) between the two groups (P>0.05). After operation， there was no statistically significant difference in levels of IgA and IgM between the two groups (P>0.05). The IgG level in RLA group was obviously higher than that in TLA group， and the difference was statistically significant (P<0.05). The incidence of complications was 5.9% in RLA group， which was obviously lower than 23.5% in TLA group， and the difference was statistically significant (P<0.05). Conclusion RLA shows affirmative efficacy for the treatment of adrenal tumor， which can shorten therapeutic time， reduce amount of intraoperative hemorrhage， accelerate the recovery of gastrointestinal function and reduce the incidence of complications. It is worthy of reference in clinical treatment., 百拇医药(高海良)