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摘要: 目的 分析、总结肾上腺囊性占位性病变的临床特征与外科手术诊治体会。方法 回顾性分析2017年6月—2022年6月在中南大学湘雅二医院确诊并接受外科手术治疗的55例肾上腺囊性占位性病变患者的临床资料，分析性别、年龄、病变侧位、肿瘤最大径、高血压病程时间、起病症状、手术方式、手术入路、手术时间、术后住院天数、输血情况、术后并发症和术后病理结果。结果 55例患者中，男22例，女33例；平均年龄为(40.1±14.1)岁；病变分布于左侧28例、右侧27例，平均病变长径为(5.15±2.30) cm；7例患者有高血压，平均病程为3年。6例患者主要以腰痛为起病症状，2例患者以心慌心悸起病，其他患者无明显症状。手术治疗中，所有患者均行腹腔镜手术，但有1例术中由腹腔镜手术中转开放手术。其中，25例采用腹腔入路，30例采用腹膜后入路。手术平均时间为(116±53) min，术后平均住院天数为(4.58±1.83) d。1例患者术后有输血。1例患者术后出现发热。术后病理结果显示，47例肾上腺内皮囊肿，6例上皮囊肿，2例假性囊肿。随访期间未见术后复发。结论 对于部分患有肾上腺囊性占位性病变的患者，采用外科手术治疗是必要的。腹腔镜手术切除可作为一种优先选择的治疗方式，而巨大的肾上腺囊性占位性病变则可考虑采用开放手术切除。Abstract: Objective To analyse and summarize the clinical characteristics and surgical management experience of adrenal cystic lesions.Methods The medical records of 55 patients diagnosed with adrenal cystic lesions and treated with surgical procedures were retrospectively reviewed from June 2017 to June 2022 in Second Xiangya Hospital of Central South University. The data included gender, age, lesion location, tumor maximum diameter, duration of hypertension, presenting symptoms, surgical methods, surgical route, operation time, duration of hospital stay, blood transfusion, postoperative complications, and postoperative pathological results.Results A total of 22 males and 33 females with adrenal cystic lesions were included in the study. The average age of the patients was (40.1±14.1) years old. Lesions were distributed on the left side in 28 cases and on the right side in 27 cases. The average maximum diameter of the lesions was (5.15±2.30) cm, with 7 patients having hypertension with an average duration of 3 years. The main presenting symptoms were lower back pain in 6 patients and palpitation in 2 patiens, while other patients were asymptomatic. In terms of surgical treatment, all the patients underwent laparoscopic surgery, but one patient turned to open surgery.Among them, 25 cases used a transperitoneal approach, and 30 cases used a retroperitoneal approach. The average surgical time was (116±53) minutes, and the average length of hospital stay was (4.58±1.83) days. Blood transfusion was performed in one patient. One patient had postoperative fever. Postoperative pathological examination showed 47 cases of adrenal endothelial cysts, 6 cases of epithelial cysts, and 2 cases of pseudocysts. During follow-up, no postoperative recurrence was observed.Conclusion Surgical treatment is a priority option for certain patients with adrenal cystic lesions. Laparoscopic resection of adrenal cystic lesions can be considered as a preferred treatment option, while large adrenal cystic lesions may require open surgical resection.
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Key words:
- adrenal /
- cystic lesion /
- surgery /
- laparoscopy
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