论文部分内容阅读
目的 比较腹腔镜肾上腺切除术三种手术入路途径的临床效果 ,探讨适宜的手术入路途径。 方法 86例接受腹腔镜肾上腺切除术。采用三种不同的手术入路途径 (经腹腔前入路即TAA ,腹膜后侧入路即RLA ,腹膜后腰入路即RPA)。 结果 通过RPA及RLA途径完成手术 ,时间短于TAA(P <0 0 1)。在RLA和RPA中输血量少于TAA。在TAA ,住院时间明显长于在RPA和RLA。在并发症发生率和中转开放手术率方面 ,TAA明显高于RPA和RLA。在RPA和RLA ,中转开放手术经常是由于胸膜撕裂 ,特别在右侧 ;而在TAA经常是由于内脏损伤。 结论 后腹膜入路更加适于腹腔镜肾上腺切除术。
Objective To compare the clinical effects of three surgical approaches of laparoscopic adrenalectomy and to explore the appropriate surgical approach. Methods 86 cases underwent laparoscopic adrenalectomy. Three different surgical approaches (TAA, retroperitoneal approach, RLA, retroperitoneal approach, or RPA) were used. Results The procedure was completed by RPA and RLA, shorter than TAA (P <0.01). Blood transfusion is less than TAA in RLA and RPA. At TAA, hospitalization was significantly longer than at RPA and RLA. TAA was significantly higher than that of RPA and RLA in terms of the incidence of complications and the rate of open surgery. In RPA and RLA, the switch to open surgery is often due to pleural tears, especially on the right; and TAA is often due to visceral damage. Conclusion Peritoneal approach is more suitable for laparoscopic adrenalectomy.