PDF(Pubmed)
Abstract：
Laparoscopic total adrenalectomy has become the standard treatment for adrenal mass. Meanwhile, there has been a growing trend toward laparoscopic adrenal-sparing surgery worldwide to avoid the risk and potential complications of adrenal insufficiency. The objectives of this study were to describe a retroperitoneoscopic adrenal tumor enucleation technique, to assess the clinical outcomes of this technique in the treatment of 20-40 mm nonsecreting adrenal tumor (NAT) with low potential of malignancy, and to provide a feasible choice for patients who have preference on resection. This study was a retrospective analysis of 61 patients with low potential of malignancy in 20-40 mm NAT identified at the first imaging examination or during follow-up. All patients were scheduled for planned enucleation adrenalectomy by a single surgeon between July 2016 and December 2020 in Xuanwu Hospital, Beijing, China. In all patients, retroperitoneoscopic surgery was performed via a retroperitoneoscopic process for all the patients. The crucial techniques of enucleation are presented in the video. Safety and feasibility factors of enucleation technique were measured for this study. No blood transfusion or organ injury was registered during the operation. The median operation time was 75 min, and the median blood loss was 35 mL. All operations were successfully performed without open conversion. A total of 58 patients received successful enucleation surgery. Three cases were converted to retroperitoneoscopic total adrenalectomy. In this study, surgical outcomes of retroperitoneoscopic enucleation adrenalectomy as a method to remove adrenal tumors were assessed. This procedure is a feasible and safe technique with the added benefit of preserving the remaining functional adrenal tissue.
摘要：
腹腔镜全肾上腺切除术已成为肾上腺肿块的标准治疗方法。同时,为了避免肾上腺功能不全的风险和潜在并发症,在全球范围内采用腹腔镜保留肾上腺手术的趋势日益明显.这项研究的目的是描述后腹腔镜肾上腺肿瘤摘除术技术，评估该技术治疗20-40mm非分泌性肾上腺肿瘤（NAT）的临床结果，并为有切除偏好的患者提供可行的选择。这项研究是对在首次影像学检查或随访期间发现的20-40mmNAT中恶性可能性低的61例患者的回顾性分析。2016年7月至2020年12月，所有患者均计划由一名外科医生在宣武医院进行计划的肾上腺摘除术。北京,中国。在所有患者中，所有患者均通过后腹腔镜进行后腹腔镜手术。视频中介绍了摘除的关键技术。本研究测量了摘除技术的安全性和可行性因素。手术期间没有输血或器官损伤。中位手术时间为75min,中位失血量为35mL。所有操作均成功执行，没有开放转换。共有58例患者接受了成功的摘除手术。3例改行后腹腔镜全肾上腺切除术。在这项研究中,评估后腹腔镜肾上腺摘除术作为切除肾上腺肿瘤的方法的手术效果.此程序是可行且安全的技术，具有保留剩余功能性肾上腺组织的额外益处。
