達文西機器手臂輔助腹腔鏡腎上腺嗜鉻細胞瘤切除手術與傳統腹腔鏡比較
李瑋涓1.2, 黃志平1,2, 張兆祥1,2, 楊啟瑞1, 陳汶吉1,2,吳錫金2,3
中國醫藥大學附設醫院 泌尿部1
中國醫藥大學 醫學系 泌尿學科2
中國醫藥大學附設北港醫院 泌尿部3
Robotic-Assisted Adrenalectomy for pheochromocytoma compared to laparoscopic approach
Wei-Juan Li1,2 , Chi-Ping, Huang1,2 ,
Chao-Hsiang Chang1,2, Chi-Rei Yang1, Wen-Chi, Chen1,2, His-Chin Wu2,3
Department of Urology, China Medical University Hospital1
Department of Urology, China Medical University2
Department of Urology, China Medical University Beigang Hospital, Beigang, Yunlin3
Purpose: Adrenalectomy for pheochromocytoma could be challenging due to intraoperative hemodynamic concern. Since laparoscopic approach (LA) is a preferred procedure, robotic-assisted laparoscopic adrenalectomy (RA) shows outstanding performance regarding to multi-jointed instruments that reducing tumor manipulation. This study compared the perioperative outcome of LA and RA.
Materials and Methods: We retrospectively reviewed 115 cases who received minimal invasive adrenalectomy between January 2017 and October 2019. Among the 115 patients, 11 subjects were reported pheochromoytoma pathologically. Eight patients received LA and three cases underwent RA. Demographic, perioperative data and postoperative outcomes were collected and statistically analyzed.
Results: In the two groups, there was no significant deference in age, body weight mass (BMI), Anesthesiologists (ASA) score, operative time, estimated blood loss, intraoperative hemodynamic parameters, hospital stay, and complication. However, more patients were administered vasopressors after tumor excised in LA group (37.5% vs. 33.3%). Moreover, 2 of the eight patients received postoperative intensive care (ICU) in LA group while none of RA group did (25% vs. 0%).
Conclusion: This study showed that robotic-assisted adrenalectomy for pheochromocytoma was a safer procedure that less possibility of vasopressors use and no postoperative intensive care needed.