后腹腔镜手术治疗肾上腺腺瘤型皮质醇增多症59例
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摘要
目的:探讨后腹腔镜治疗腺瘤型皮质醇增多症的临床价值。方法:对59例腺瘤型皮质醇增多症患者行后腹腔镜手术治疗,其中行肾上腺全切术19例,肾上腺部分切除术40例,术后均辅以激素替代疗法。结果:59例均手术成功,随访6～24个月,全部患者临床症状均有不同程度的缓解,术后无肾上腺皮质功能不全现象发生。结论:后腹腔镜下行肾上腺全切或部分切除术治疗腺瘤型皮质醇增多症,安全性和疗效肯定,术后辅以改良激素替代疗法安全有效。
Objective To evaluate the clinical efficacy of retroperitoneal laparoscopic adrenalectomy for Cushing syndrome with adrenaladenoma. Methods Fifty-nine patients(4 males and 55 females) who underwent retroperitonel laparoscopic adrenalectomy for Cushing syndrome with adrenaladenoma were enrolled in this study.Among them ,19 cases underwent total adrenalectomy and 40 cases underwent partial adrenalectomy.All the cases were adopted the improved corticoid substitution therapy. Results Surgery was successfully performed in all the patients. All cases were followed up from 6 months to 24 months. The clinical symptoms of all cases relieved in varying degrees, without any postoperative adrenal insufficiency phenomenon. Conclusion Retroperitoneal laparoscopic partial or total adrenalectomy for treatment of Cushing syndrome with adrenaladenoma is reliable and safe, besides, postoperative improved corticoid substitution therapy is safe and effective.
Objective To evaluate the clinical efficacy of retroperitoneal laparoscopic adrenalectomy for Cushing syndrome with adrenaladenoma. Methods Fifty-nine patients(4 males and 55 females) who underwent retroperitonel laparoscopic adrenalectomy for Cushing syndrome with adrenaladenoma were enrolled in this study.Among them ,19 cases underwent total adrenalectomy and 40 cases underwent partial adrenalectomy.All the cases were adopted the improved corticoid substitution therapy. Results Surgery was successfully performed in all the patients. All cases were followed up from 6 months to 24 months. The clinical symptoms of all cases relieved in varying degrees, without any postoperative adrenal insufficiency phenomenon. Conclusion Retroperitoneal laparoscopic partial or total adrenalectomy for treatment of Cushing syndrome with adrenaladenoma is reliable and safe, besides, postoperative improved corticoid substitution therapy is safe and effective.
引文
[1]李黎明,林毅,朱军,等.后腹腔镜手术治疗肾上腺疾病(附52例报告)[J].中华泌尿外科杂志,2002,23(7):389-391.
[2]Shonkwiler RJ, Lee JA.Laparoscopic retroperitoneal drenalectomy[J].Surg Laparosc Endosc Percutan Tech,2011,21(4):243-247.
[3]汤坤龙,杨长海,李黎明.后腹腔镜手术治疗腺瘤型原发性醛固酮增多症205例临床分析[J].中华全科医师杂志,2011,10(8):583-585.
[4]谢欣,沈周俊,王晓晶,等.后腹腔镜肾上腺切除术(附193例报告)[J/CD].中华腔镜泌尿外科杂志,2008,2(2):131-134.
[5]He HC,Dai J,Shen ZJ,et al.Retroperitoneal Adrenal-Sparing Sur gery for the Treatment of Cushing’s Syndrome Caused by Adreno cortical Adenoma:8-Year Experience With87Patients[J].WorldJ Surg,2012,36(5):1182-1188.
[6]Walz MK,Peitgen K,Diesing D,et al.Partial versus total adrenalectomy by the posterior retroperitoneoscopic approach:early and long-term results of325consecutive procedures in primary adre nal neoplasias[J].world J Surg,2004,28(12):1323-1329.
[7]Young WF Jr,Thompson GB.Role for laparoscopic adrenalectomy in patients with Cushing's syndrome[J].Arq Bras Endocrinol Me tabol,2007,51(8):1349-1354.
[8]宁光.糖皮质激素类药物临床应用指导原则[J].中华内分泌代谢杂志,2012,28(2):2a4-2a9.
[9]Mishra AK,Agarwal A,Gupta S,et al.Outcome of adrenalectomy for Cushing’s syndrome:experience from a tertiary care center[J].World J Surg,2007,31(7):1425-1432.
[2]Shonkwiler RJ, Lee JA.Laparoscopic retroperitoneal drenalectomy[J].Surg Laparosc Endosc Percutan Tech,2011,21(4):243-247.
[3]汤坤龙,杨长海,李黎明.后腹腔镜手术治疗腺瘤型原发性醛固酮增多症205例临床分析[J].中华全科医师杂志,2011,10(8):583-585.
[4]谢欣,沈周俊,王晓晶,等.后腹腔镜肾上腺切除术(附193例报告)[J/CD].中华腔镜泌尿外科杂志,2008,2(2):131-134.
[5]He HC,Dai J,Shen ZJ,et al.Retroperitoneal Adrenal-Sparing Sur gery for the Treatment of Cushing’s Syndrome Caused by Adreno cortical Adenoma:8-Year Experience With87Patients[J].WorldJ Surg,2012,36(5):1182-1188.
[6]Walz MK,Peitgen K,Diesing D,et al.Partial versus total adrenalectomy by the posterior retroperitoneoscopic approach:early and long-term results of325consecutive procedures in primary adre nal neoplasias[J].world J Surg,2004,28(12):1323-1329.
[7]Young WF Jr,Thompson GB.Role for laparoscopic adrenalectomy in patients with Cushing's syndrome[J].Arq Bras Endocrinol Me tabol,2007,51(8):1349-1354.
[8]宁光.糖皮质激素类药物临床应用指导原则[J].中华内分泌代谢杂志,2012,28(2):2a4-2a9.
[9]Mishra AK,Agarwal A,Gupta S,et al.Outcome of adrenalectomy for Cushing’s syndrome:experience from a tertiary care center[J].World J Surg,2007,31(7):1425-1432.