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目的探讨原发性醛酮增多症的腹腔镜微创手术治疗。方法我院经腹腔入路腹腔镜治疗原发性醛固酮增多症患者共47例。肾上腺皮质腺瘤43例,肿瘤平均2.0 cm,32例行肾上腺全切术,11例行肾上腺部分切除术/肿瘤剜除术;肾上腺皮质增生4例,行肾上腺全切术。结果手术时间50~240m in,平均80m in;术中失血量20~300m l,平均76m。l中转开放手术2例(4.2%),其余手术成功。无严重并发症发生。所有患者术后第1天下床活动,术后平均住院时间5d。平均随访16个月,所有患者血钾恢复正常,35例血压恢复正常,其余患者降压药物用量较术前明显减少。结论腹腔入路腹腔镜肾上腺全切术或部分切除/肿瘤剜除术治疗原发性醛固酮增多症,微创、安全、疗效确切。
Objective To investigate the treatment of primary aldosteronism by laparoscopic minimally invasive surgery. Methods A total of 47 patients with primary aldosteronism were treated with laparoscopic transperitoneal approach in our hospital. 43 cases of adrenocortical adenoma, the average tumor 2.0 cm, 32 cases of total adrenalectomy, 11 cases of partial adrenalectomy / tumor resection; adrenal hyperplasia in 4 cases, adrenalectomy. Results The operation time was 50 ~ 240m in with an average of 80m in. The intraoperative blood loss was 20 ~ 300m l with an average of 76m. l open surgery in 2 cases (4.2%), the remaining surgery was successful. No serious complications occurred. All patients on the first day after bed activity, average postoperative hospital stay 5d. After an average follow-up of 16 months, all patients returned to normal levels of serum potassium and 35 patients returned to normal blood pressure, while the remaining patients took less antihypertensive drugs than those preoperatively. Conclusion Laparoscopic adrenalectomy or partial resection / tumor resection for primary aldosteronism is minimally invasive, safe and effective.