| Objective: To analyze the clinical effect of retroperitoneal laparoscopic adrenalectomy with three sides and one line,so as to provide reference basis for clinical resection of adrenal tumors.Method: A collection of patients with primary adrenal tumors diagnosed by the Department of Urology,Yanbian University Affiliated Hospital from January 2005 to January 2013,underwent retroperitoneal laparoscopic adrenal tumor resection(retroperitoneal laparoscopic adrenal tumor resection RLA)and open surgery(The clinical data of open adrenal tumor resection OA)were retrospectively compared and studied.There were 98 cases in the RLA group and 51 cases in the OA group.Pathological examinations were performed to confirm the diagnosis,and the average operation time,intraoperative blood loss,average postoperative drainage tube withdrawal time,hospital stay,postoperative analgesia time,gastrointestinal function recovery time,intraoperative blood transfusion cases,postoperative statistics For drainage,intraoperative and postoperative complications,statistical software was used for statistical analysis of the two groups of data.Results:1.There are 149 cases in the two groups,including 51 cases in the OA group and 98 cases in the RLA group.The two groups of patients were not statistically significant in gender,age,tumor location,and size(p>0.05).2.There were significant differences between OA group and RLA group in tumor diameter(3.61 ±1.66 cm vs 2.44 ±1.23 cm),average operation time(118.33±21.83 min vs 89.64 ±19.01min)and intraoperative blood loss(75.78 ±20.53 m lvs28.47 ±12.18ml)between),RLA group and OA group(p<0.05).3.There were significant differences between OA group and RLA group in hospitalization time(9.94 ±2.20 d vs 5.43 ±1.02d),postoperative analgesia time(2.33±0.47 d vs 1.12 ±0.45d),gastrointestinal function recovery time(2.83 ±0.68 d vs 1.19±0.29d),drainage tube indwelling time(4.51 ±1.16 d vs 2.43 ±0.84d),drainage volume(220.59 ±37.49 ml vs 122.96± 30.76ml),RLA group and OA group)(p<0.05).4.All operations were successful in OA group,1 case in RLA group was changed to open operation,1 case in RLA group and 3 cases in OA group.There was no significant difference in the number of intraoperative blood transfusions between the two groups(p>0.05).5.In the RLA group,there were 1 case of intraoperative pleural injury,4 cases of peritoneal injury,2 cases of hypertensive crisis,1 case of large vessel injury,2 cases of organ injury,1 case of pleural injury in the OA group,2 cases of peritoneal injury,and risk of hypertension There were 5 cases,2 cases of large blood vessel injury,2cases of organ injury,4 cases of postoperative complications in the RLA group,poor healing of incisions,1 case of postoperative infection and fever,2 cases of incision pain,3 cases of subcutaneous emphysema,and 0 cases of incision fat liquefaction.In the OA group,there were 1 case of cortical insufficiency,4 cases of poor incision healing in the OA group,3 cases of postoperative infection and fever,6 cases of incision pain,2 cases of subcutaneous emphysema,3 cases of incision fat liquefaction,and 3 cases of cortical insufficiency.The RLA group had obvious advantages in intraoperative and postoperative complications,and the comparison between the two was statistically significant(p<0.05)Conclusion:1.Three-sided,one-line adrenal tumor resection under retroperitoneal laparoscopic surgery has clear steps and clear anatomical levels.The curative effect is definitely a safer choice for minimally invasive surgical treatment of adrenal tumors.2.Retroperitoneal laparoscopic three-sided one-line adrenal tumor resection has the advantages of less trauma,less bleeding,faster recovery and fewer complications,which is the first choice for the treatment of adrenal tumors. |
PDF Full Text Request