标题：后腹腔镜下肾上腺嗜铬细胞瘤切除术安全性分析

      作者：柯为，葛成国，朱海林，唐安辉，徐光勇，张唯力    (重庆医科大学附属第二医院泌尿外科，重庆 400010)

      卷次： 2018年29卷20期

      【摘要】 目的 探讨后腹腔镜肾上腺嗜铬细胞瘤切除术的可行性和安全性。方法 回顾性分析重庆医科大学附属第二医院泌尿外科2014年5月至2017年7月收治的14例肾上腺嗜铬细胞瘤患者的临床资料。所有患者均行经后腹腔镜下手术治疗，其中6例位于左侧，8例位于右侧，肿瘤最大直径2.7~7.2 cm，平均4.4 cm。伴阵发性高血压或持续性高血压患者11例，24 h尿香草基杏仁酸(VMA)水平升高者8例，尿儿茶酚胺(UCA)升高者10例。结果 14例均行经后腹腔镜下切除，无中转开放手术。8例患者出现血压波动，其中2例出现高血压危象，6例发生低血压。平均手术时间(110±24) min，平均出血量(118±23) mL。术后病理证实均为嗜铬细胞瘤，术后平均住院(4.3±1.7) d，术后平均随访2.4年，2例血压偏高需口服药物控制，其余12例患者血压降至正常水平，生化指标均恢复正常。结论 肾上腺嗜铬细胞瘤患者采用后腹腔镜切除术安全、微创且患者术后恢复快。
      【关键词】 后腹腔镜；嗜铬细胞瘤；肾上腺切除术；安全性
      【中图分类号】 R736.6 【文献标识码】 A 【文章编号】 1003—6350（2018）20—2894—04

Safety analysis of retroperitoneal laparoscopic adrenalectomy of adrenal pheochromocytoma.
KE Wei, GECheng-guo, ZHU Hai-lin, TANG An-hui, XU Guang-yong, ZHANG Wei-li. Department of Urology, the Second AffiliatedHospital of Chongqing Medical University, Chongqing 400010, CHINA
【Abstract】 Objective To investigate the feasibility and safety of retroperitoneal laparoscopic adrenalectomy ofadrenal pheochromocytoma. Methods The clinical data of 14 patients with adrenal pheochromocytoma treated in thesecond Affiliated Hospital of Chongqing Medical University from May 2014 to July 2017 were reviewed retrospectively.All patients underwent retroperitoneal laparoscopic surgery, of which 6 cases were located on the left side and 8 caseswere on the right side. The average diameter was 4.4 cm (ranged from 2.7 cm to 7.2 cm). Totally 11 cases suffered frompersistent or intermittent hypertension. The 24 h urinary catecholamines (UCA) or vanillylmandelic acid (VMA) in-creased significantly in 10 cases and 8 cases respectively. Results All the operations were technically successful, with-out conversion to open procedures. Intraoperative blood pressure lability occurred in 8 patients, with hypertension crisisin 2 patients and hypotension in 6 respectively. The mean operative time was (110±24) min, and the estimated blood losswas (118±23) mL. Histopathology confirmed the diagnosis of pheochromocytoma. The average hospitalization after op-eration was (4.3±1.7) d. All patients were followed up for an average of 2.4 years; Two patients with high blood pressureshould be controlled by oral medication, and the blood pressure of the remaining 12 patients was reduced to normal lev-el, with the biochemical indexes returned to normal. Conclusion Retroperitoneal laparoscopic adrenalectomy for thetreatment of phenochromocytoma in selected patients is a safe and minimally invasive procedure, with less postoperativepain and faster recovery.
      【Key words】 Retroperitoneal laparoscopic; Pheochromocytoma; Adrenalectomy; Safety·短篇论著·doi:10.3969/j.issn.1003-6350.2018.20.025