Retroperitoneoscopic adrenalectomy for adrenal tumors via a single large port

被引:112
作者
Hirano, D [1 ]
Minei, S [1 ]
Yamaguchi, K [1 ]
Yoshikawa, T [1 ]
Hachiya, T [1 ]
Yoshida, T [1 ]
Ishida, H [1 ]
Takimoto, Y [1 ]
Saitoh, T [1 ]
Kiyotaki, S [1 ]
Okada, K [1 ]
机构
[1] Nihon Univ, Sch Med, Dept Urol, Itabashi Ku, Tokyo 1738610, Japan
关键词
D O I
10.1089/end.2005.19.788
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Background and purpose: Laparoscopic adrenalectomy is generally performed with carbon dioxide insufflation of the cavity and requires multiple trocars. This study reports the outcomes of retroperitoneoscopic adrenalectomy (RA) for adrenal tumors via a single port using a large cylinder without carbon dioxide insufflation. Patients and Methods: Fifty-four patients with adrenal tumors were treated using RA via a single large port. The average tumor size was 2.6 cm. For surgery, patients were placed in the lateral decubitus position with slight flexion, and a 4.5-cm skin incision was performed below the 12th rib in the midaxillary line. The retroperitoneal space was dissected using index fingers and a balloon dilator. A rectoscope tube with a 4-cm diameter was inserted, and the adrenal glands were removed endoscopically via the single large port without carbon dioxide insufflation. Results: This procedure was completed in 53 patients (98.1%). The average duration of surgery was 203 minutes, and the mean estimated blood loss wag 252 mL. Four patients (7.4%) required blood transfusion. Postoperative major complications, including fulminant hepatitis and pulmonary thrombosis, were observed in two patients (3.7%), and the patient with hepatic disease died on the 14th postoperative day. The mortality rate after surgery thus was 1.9%. However, no local tumor recurrence or hormonal relapse has occurred at a median follow-up of 34 months. Conclusions: This procedure appears to be effective and relatively minimally invasive. However, it is limited by the narrow working space and restriction of the manipulation of instruments.
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收藏
页码:788 / 792
页数:5
相关论文
共 20 条
[1]   A posterior lumbar approach for retroperitoneoscopic adrenalectomy: Assessment of surgical efficacy [J].
Baba, S ;
Miyajima, A ;
Uchida, A ;
Asanuma, H ;
Miyakawa, A ;
Murai, M .
UROLOGY, 1997, 50 (01) :19-24
[2]  
Bonjer HJ, 2000, ANN SURG, V232, P796, DOI 10.1097/00000658-200012000-00008
[3]   ENDOSCOPIC SURGERY IN THE RECTUM [J].
BUESS, G ;
THEISS, R ;
GUNTHER, M ;
HUTTERER, F ;
PICHLMAIER, H .
ENDOSCOPY, 1985, 17 (01) :31-35
[4]   LAPAROSCOPY IN UROLOGY - PERSPECTIVES AND PRACTICE [J].
COPTCOAT, MJ .
BRITISH JOURNAL OF UROLOGY, 1992, 69 (06) :561-567
[5]   Is laparoscopic adrenalectomy indicated for pheochromocytomas? [J].
Gagner, M ;
Breton, G ;
Pharand, D ;
Pomp, A .
SURGERY, 1996, 120 (06) :1076-1079
[6]   LAPAROSCOPIC ADRENALECTOMY - THE IMPORTANCE OF A FLANK APPROACH IN THE LATERAL DECUBITUS POSITION [J].
GAGNER, M ;
LACROIX, A ;
BOLTE, E ;
POMP, A .
SURGICAL ENDOSCOPY-ULTRASOUND AND INTERVENTIONAL TECHNIQUES, 1994, 8 (02) :135-138
[7]   Laparoscopic adrenalectomy: The retroperitoneal approach [J].
Gasman, D ;
Droupy, S ;
Koutani, A ;
Salomon, L ;
Antiphon, P ;
Chassagnon, J ;
Chopin, DK ;
Abbou, CC .
JOURNAL OF UROLOGY, 1998, 159 (06) :1816-1820
[8]  
Go H, 1993, J Laparoendosc Surg, V3, P455, DOI 10.1089/lps.1993.3.455
[9]   Learning curve and conversion to open surgery in cases of laparoscopic adrenalectomy and nephrectomy [J].
Higashihara, E ;
Baba, S ;
Nakagawa, K ;
Murai, M ;
Go, H ;
Takeda, M ;
Takahashi, K ;
Suzuki, K ;
Fujita, K ;
Ono, Y ;
Ohshima, S ;
Matsuda, T ;
Terachi, T ;
Yoshida, O .
JOURNAL OF UROLOGY, 1998, 159 (03) :650-653
[10]   LAPAROSCOPIC ADRENALECTOMY - THE INITIAL 3 CASES [J].
HIGASHIHARA, E ;
TANAKA, Y ;
HORIE, S ;
ARUGA, S ;
NUTAHARA, K ;
MINOWADA, S ;
ASO, Y .
JOURNAL OF UROLOGY, 1993, 149 (05) :973-976