單孔腹腔鏡腎上腺切除術
李香瑩、李經家、葉信志、蔡嘉駿、闕光瞬、周以和、黃俊農、吳文正
高雄市立大同醫院
Laparoendoscopic single site (LESS) adrenalectomy for adrenal tumors
Hsiang Ying Lee1,2, Ching-Chia Li1,2, Hsin-Chih Yeh1,2, Chia-Chun Tsai1,2, Kuang-Shun Chueh1,2, Yii-her Chou2, Chun-Nung Huang2, Wen-Jeng Wu2,3
1Department of Urology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan;
2Kaohsiung Medical University Hospital, Kaohsiung, Taiwan;
3Department of Urology, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung, Taiwan
Purpose:
Laparoendoscopic single site (LESS) adrenalectomy have become a feasible choice for adrenal lesions and is substitute to conventional open adrenalectomy. This study is to describe the characteristics of adrenal tumor after LESS retroperitoneal adrenalectomy in our experience.
Materials and Methods:
Between 2010 to 2014, 87 adrenalectomies were performed. OF all patients, 79 received a LESS retroperitoneal approach and were done by one surgeon. We retrospectively review these patients and analyze the characteristics of adrenal tumors. The incision wound is below the 12th rib in the posterior axillary line and is about 2.3 to 3.2cm length. A 5mm 300 rigid laparoscope and other conventional laparoscopic instruments are manipulated via a commercial port (LagiPort). After operation, no drain tube is placed.
Results:
Among 79 adrenal tumors receiving operation, Conn’s disease is the most common disease (60% Conn’s disease, 22% non-functional, 6% Cushing disease, 4% Pheochromocytoma, 3% malignancy, respectively). In our finding, left side adrenal tumors (60.76%) are more than right side tumors (39.24%). Mean operating time was 116 min and mean blood loss was 67ml. Mean hospital stay was 5 days. The postoperative course was uneventful without complications.
Conclusions:
LESS retroperitoneal adrenalectomy is a safe and satisfied procedure for patients with adrenal tumors. Besides, we discovered the different distribution of adrenal disease between Asian and Western world. Conn’s disease takes more than half of adrenal tumors in Taiwanese population.