經腹腔之腹腔鏡部分腎上腺切除手術在單側腎上腺腺瘤的應用
徐易廷1、薛又仁1,3、柯明中2、黃建榮1、蕭毅君1、賴昱維1,3、邱文祥1,3
1臺北市立聯合醫院仁愛院區 外科部 泌尿科；2臺北市立聯合醫院中興院區 外科部 泌尿科3國立陽明大學 醫學院 泌尿學科
Application of transperitoneal laparoscopic partial adrenalectomy in patient with unilateral adenoma
Yi-Ting Hsu1, Thomas Y. Hsueh1,3, Ming-Chung Ko2, Andy. C. Huang1, Yi-Chun Hsiao1, Yu-Wei Lai1,3, Allen W. Chiu1,3
1Division of Urology, Department of Surgery, Taipei City Hospital renai Branch, Taipei, Taiwan;
2Division of Urology, Department of Surgery, Taipei City Hospital zhongxing Branch, Taipei, Taiwan;
3Department of Urology, School of Medicine, National Yang-Ming University, Taipei, Taiwan
Background: Laparoscopic partial adrenalectomy has been proven feasible but lacks definite consensus regarding indications and techniques in published literatures. Most authors agree that functioning tumors with less than 3 cm in diameter and peripheral lesion location represent an indication for partial resection. Transperitoneal approach is commonly used for performing laparoscopic partial adrenalectomy.
Presentation of case: The patient was a 41-year-old female with an incidental left adrenal mass measuring 3.5 cm in diameter on computed tomography imaging. She was diagnosed with subclinical hypercortisolism. She underwent laparoscopic left partial adrenalectomy via transperitoneal approach. Total operative time was 150 minutes and total blood loss was 200 ml. No perioperative complication was recorded. The patient evolved with an uneventful postoperative period, and was discharged within 8 days postoperatively. The specimen was a well-circumscribed, yellowish brown, solid tumor measuring 3.5 x 2.9 x 2.0 cm and weighing 26.0 gm. The adrenal pathology disclosed cortical adenoma.
Conclusions: It is concluded that the transperitoneal laparoscopic partial adrenalectomy is a feasible and effective surgical approach for patients with unilateral adenoma.