摘要
Objective: To examine the safety and efficacy of laparoscopic adrenalectomy with needlescopic instruments for most adrenal tumors less than 5 cm. Methods: Transperitoneal laparoscopic adrenalectomy with needlescopic instruments for 112 patients with presumptively benign adrenal tumors < 5 cm were enrolled from July 2000 to February 2005. Operative time, blood loss, conversion and complication rates, and postoperative data were analyzed by appropriate statistical methods. Results: All 112 operations were completed without any mortality or reoperation. Mean operative time was 151 min and mean blood loss was 30 ml. Only one patient required a blood transfusion and application of a hand-assisted device. Conversion to conventional laparoscopic instruments was necessary in another five patients (4.5%). The operative time of the latter 100 cases (147 ± 5.1 min, mean ± standard error of mean) was significantly shorter than that of the initial 12 cases (183 ± 8.8 min, p = 0.001). Larger tumors, previous abdominal surgery, and pheochromocytoma group were independent risk factors of a longer operative time. Except for one leiomyosarcoma, all other tumors were benign adrenal pathologies (57 aldosterone-producing adenomas, 23 Cushing's adenomas, 12 pheochromocytomas, and 20 incidentalomas). Conclusion: The safety and effectiveness of laparoscopic adrenalectomy employing needlescopic instruments for most adrenal tumors less than 5 cm was feasible with acceptable operative time. Pheochromocytomas can also be managed with a longer operative time. Patients with previous upper midline or ipsilateral upper quadrant open surgery might not be suitable candidates for such a technique.
原文 | 英語 |
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頁(從 - 到) | 640-646 |
頁數 | 7 |
期刊 | European Urology |
卷 | 54 |
發行號 | 3 |
DOIs | |
出版狀態 | 已出版 - 09 2008 |
對外發佈 | 是 |