改良新层面法联合后腹腔入路3D腹腔镜下肾上腺切除术在治疗肾上腺肿瘤精准手术中的应用价值

Application value of modified new plane method combined with retroperitoneal approach 3D laparoscopic adrenalectomy in precision surgery for adrenal tumors

摘要:

目的 评估改良新层面法联合后腹腔入路3D腹腔镜肾上腺切除术在肾上腺肿瘤精准外科治疗中的临床应用效果及其价值。方法 选取2022年10月－2024年12月该院接诊的肾上腺肿瘤患者80例，按照随机数表法，将患者分为实验组和对照组，各40例。实验组采用改良新层面法联合后腹腔入路3D腹腔镜肾上腺切除术，对照组采用传统后腹腔镜肾上腺切除术。比较两组患者手术相关指标、术中和术后并发症发生率，以及随访情况。结果 实验组手术时间、肾上腺中央静脉识别时间、术后下床活动时间、肛门排气时间、引流管拔除时间和住院时间明显短于对照组，术中出血量明显少于对照组，差异均有统计学意义（P < 0.05）；两组患者术中均未发生输血和中转开放手术情况，两组患者术后并发症总发生率比较，差异无统计学意义（P > 0.05）；对照组术中并发症总发生率明显高于实验组，差异有统计学意义（P < 0.05）。所有患者均完成随访，无失访案例，未出现局部复发或远处转移等情况。结论 改良新层面法联合后腹腔入路3D腹腔镜肾上腺切除术治疗肾上腺肿瘤安全、有效。值得临床推广应用。

Abstract:

Objective To evaluate the clinical application effect and value of the modified new plane method combined with retroperitoneal approach 3D laparoscopic adrenalectomy in the precise surgical treatment of adrenal tumors.Methods 80 patients with adrenal tumors from October 2022 to December 2024 were selected as research samples. According to the random number table method, the patients were divided into the experimental group and the control group, with 40 cases in each group. The experimental group was treated with the modified new plane method combined with retroperitoneal approach 3D laparoscopic adrenalectomy, while the control group was treated with traditional retroperitoneal laparoscopic adrenalectomy. The surgical-related indicators, the incidence of intraoperative and postoperative complications, and the follow-up conditions of the two groups of patients were compared.Results The operation time, recognition time of the adrenal central vein, postoperative out-of-bed activity time, anal exhaust time, drainage tube removal time and hospital stay in the experimental group were significantly shorter than those in the control group, and the intraoperative blood loss was significantly less than that in the control group. The differences were statistically significant (P < 0.05). No blood transfusion or conversion to open surgery occurred during the operation in both groups of patients. There was no statistically significant difference in the total incidence of postoperative complications between the two groups (P > 0.05). The total incidence of intraoperative complications in the control group was significantly higher than that in the experimental group, and the difference was statistically significant (P < 0.05). All patients were followed up. There were no cases of loss to follow-up, and no local recurrence or distant metastasis occurred.Conclusion The modified new plane method combined with retroperitoneal approach 3D laparoscopic adrenalectomy is safe and effective in the treatment of adrenal tumors. It is worthy of clinical promotion and application.