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摘要: 目的探讨日间模式下的后腹腔镜肾上腺肿瘤切除术的可行性与安全性。方法回顾性分析郑州大学第一附属医院2019年1月—2020年10月行后腹腔镜肾上腺肿瘤切除术80例患者的临床资料。80例患者均为单侧肾上腺无功能腺瘤或原醛瘤，术后病理报告也均为肾上腺皮质来源的腺瘤，其中日间模式组30例，普通模式组50例。比较两组手术时间、术中出血量、肠道功能恢复时间、围术期并发症发生率、总住院天数及术后住院时间等资料。结果日间模式组与普通模式组手术时间与术中出血量均差异无统计学意义。两组术后肠道功能恢复时间[(1.02±0.44) d vs.(1.64±0.67) d，P < 0.05]及术后住院时间[(1.50±0.73) d vs.(5.46±1.01) d，P < 0.05]均差异有统计学意义。普通模式组有更高的并发症发生率，但差异无统计学意义。日间模式组3例因个人其他原因延长住院，无返院治疗患者。结论选择合适的无功能肾上腺瘤或者原醛瘤患者，在加速康复理念指导下经过充分的术前准备及严格的围术期管理，行后腹腔镜肾上腺切除日间外科手术是安全可行的。Abstract: ObjectiveTo explore the feasibility and safety of laparoscopic adrenal tumor resection in daytime mode.MethodsThe clinical data of 80 patients undergoing retroperitoneal laparoscopic adrenal tumor resection from January 2019 to October 2020 in First Affiliated Hospital of Zhengzhou University were retrospectively analyzed, including 30 patients in the day mode group and 50 patients in the normal mode group. All 80 patients presented with unilateral adrenal nonfunctional adenoma or primary aldosterone-producing adenoma, and postoperative pathological reports showed adenoma of adrenal cortex origin. The data of operation time, intraoperative blood loss, bowel recovery time, perioperative complication rate, total hospital stay, and postoperative hospital stay were compared between the two groups.ResultsThere was no statistically significant difference in operation time or intraoperative blood loss between the day mode group and the normal mode group. There were significant differences in the postoperative intestinal recovery time[(1.02±0.44)d vs. (1.64±0.67)d, P < 0.05]and the postoperative hospital stay[(1.50±0.73) d vs. (5.46±1.01)d, P < 0.05] between the two groups. The normal model group had a higher incidence of complications, but the difference was not statistically significant. In the day model group, 3 patients prolonged hospitalization for other personal reasons, but no patients returned to hospital for treatment.ConclusionFor selected patients with adrenal nonfunctional adenoma or primary aldosterone-producing adenoma, retroperitoneal laparoscopic adrenalectomy day surgery is safe and feasible after full preoperative preparation and strict perioperative management under the guidance of the enhanced recovery after surgery concept.
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表 1 普通模式组与日间模式组患者围术期相关情况
X±S 项目 普通模式组(50例) 日间模式(30例) P值 手术时间/min 101.80±12.29 100.60±14.21 0.691 术中出血量/mL 22.10±6.48 22.17±6.25 0.964 胃肠功能恢复时间/d 1.64±0.67 1.02±0.44 < 0.05 住院时间/d 11.22±1.27 1.50±0.73 < 0.05 术后住院时间/d 5.46±1.01 1.50±0.73 < 0.05 并发症发生率/例(%) 8(16.0) 2(6.7) 0.383 
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| 引用本文: |
张二伟, 徐进松, 李冠儒, 等. 日间模式下的腹腔镜肾上腺肿瘤切除术的临床研究[J]. 临床泌尿外科杂志, 2022, 37(11): 866-868. doi: 10.13201/j.issn.1001-1420.2022.11.013
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| Citation: |
ZHANG Erwei, XU Jinsong, LI Guanru, et al. Clinical study of laparoscopic adrenal tumor resection in daytime mode[J]. J Clin Urol, 2022, 37(11): 866-868. doi: 10.13201/j.issn.1001-1420.2022.11.013
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