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目的比较后腹腔镜与开放手术治疗小儿肾上腺肿瘤的临床疗效和随访结果。方法回顾分析我院2002年6月-2009年3月38例行后腹腔镜肾上腺手术和32例开放肾上腺手术治疗小儿肾上腺肿瘤患者的临床资料,对两组的临床疗效及随访结果等进行对比分析。结果两组在发病年龄、肿瘤大小、手术时间比较差异无统计学意义;两组平均术中出血量、术后肠功能恢复时间、术后止痛药的应用及术后住院天数分别为:(95.4±32.0)ml和(155.3±41.7)ml;(1.5±0.4)d和(2.8±1.5)d;21.1%和50%;(5.5±0.8)d和(8.5±2.1)d,两组比较差异有统计学意义(P<0.05)。后腹腔镜组术后并发症少于开放组。两组病例的5年无复发生存率及5年生存率比较差异无统计学意义。结论后腹腔镜小儿肾上腺肿瘤切除术与开放手术相比,疗效相当,创伤小、痛苦少、术后恢复快、并发症少,可作为小儿肾上腺肿瘤切除的首选治疗方法。
Objective To compare the clinical effects and follow-up results of retroperitoneal laparoscopy and open surgery in pediatric adrenal tumors. Methods A retrospective analysis of our hospital from June 2002 to March 2009 38 cases of laparoscopic adrenalectomy and 32 cases of adrenal surgery in children with adrenal tumors in patients with clinical data on the two groups of clinical efficacy and follow-up results were compared . Results There was no significant difference in age of onset, tumor size and operation time between the two groups. The average amount of blood loss during operation, the recovery time of postoperative bowel function, the application of postoperative analgesics and postoperative hospital stay were (95.4 (1.5 ± 0.4) d and (2.8 ± 1.5) d; 21.1% and 50%; (5.5 ± 0.8) d and (8.5 ± 2.1) d, respectively There was statistical significance (P <0.05). Postoperative laparoscopic surgery less complications than open group. The 5-year recurrence-free survival rate and 5-year survival rate were not significantly different between the two groups. Conclusions Retroperitoneal laparoscopic pediatric adrenal tumor resection has the same curative effect, less trauma, less pain, quick recovery after operation and fewer complications. It can be used as the first choice for the treatment of pediatric adrenal tumor resection.