| Objective:To compare the efficacy and safety of single-layer and conventional three-layer separation of retroperitoneal laparoscopy in the treatment of adrenal tumors,and explore the clinical value of single-layer separation in retroperitoneal laparoscopic adrenalectomy.Clinical data and methods:The clinical data of 131 patients with adrenal tumors diagnosed by urology department of China-Japan Union Hospital of JILIN University from October 2016 to October 2018 were retrospectively analyzed and all patients underwent retroperitoneal laparoscopic adrenalectomy.There were 61 cases in single-layer group(ventral surface,group A)and 70 cases in conventional three-level group(ventral surface,dorsal surface,renal surface,group B).The operation time,estimated bleeding volume during operation,recovery time of gastrointestinal function,indwelling time of drainage tube,hospitalization time after operation and intraoperative and postoperative complications were counted and compared between the two groups.Results:In this study,131 cases of surgery were successfully completed without transferring to open.There were 61 cases in group A,33 cases with tumors on the left and 28 cases on the right;there were 70 cases in group B,37 cases with tumors on the left and 33 cases on the right.The average diameter of adrenal tumors in the two groups were 1.9±0.6cmand 2.0±0.8cm;the average operation time in the two groups were44.61±12.44 min and 61.50±15.69min;the estimated intraoperative blood loss in the two groups were 36.72±12.87 ml and 55.00±19.24ml;the postoperative recovery time of gastrointestinal function in the two groups were 21.91±5.04 h and 23.32±4.63h;the removal time of drainage tube after operation in the two groups were 4.11±1.08 days and 3.93±1.20 days.The postoperative hospitalization time in group A was 5.77±1.30 d,and that in group B was 6.07±1.42 d.Two groups did not appear serious complications,such as organ injury,major vessels hemorrhage,and pleural damage.In group A,there were 3 cases of intraoperative peritoneum injury and 2 cases of subcutaneous emphysema,without incision infection,with incidence of complications of 8.2%;in group B,there were 5 cases of intraoperative peritoneum injury,3 cases of subcutaneous emphysema,and 1 case of incision infection with fat liquefaction,with incidence of complications of 12.9%.There were statistically significant differences between the two groups in terms of operative time and estimated intraoperative blood loss(P < 0.05),while there were no significant differences in recovery time of gastrointestinal function,indwelling time of drainage tube,hospitalization time after operation and incidence of complications during and after operation(P>0.05).Conclusion:1.Single-layer separation in retroperitoneal laparoscopic adrenalectomy is as effective as conventional three-level separation in the treatment of adrenal tumors,which can achieve the goal of complete removal of adrenal tumors and improving the clinical symptoms of patients.2.Single-layer separation has the advantages of shorter operation time and less intraoperative bleeding.In both groups,there was nosignificant differences in the incidence of complications and postoperative recovery. |
