腹腔鏡下副腎摘出術7例の経験

Abstract

2年間に7例の腹腔鏡下副腎摘出術を経験した.うち5例は成功, 2例は手術途中で開腹術にきりかえた.腹腔鏡下副腎摘出術は, 開腹術と比較してあきらかに時間はかかるものの, 出血量は症例によってはむしろ少なくてすむ

We have experienced 7 cases of laparoscopic adrenalectomy for adrenal tumors during the past two years since our department opened in July, 1992. In four cases, the tumors were clinically diagnosed preoperatively as primary aldosteronism and in the other three cases as endocrine-inactive tumors. Four tumors were found on the left adrenal and three on the right. Five tumors were successfully resected with laparoscopic surgery, but in the other two cases it was immediately followed by open surgery because of an uncontrollable hemorrhage. Laparoscopically unresected tumors existed, one on the right and the other on the left adrenal. The average operation time for laparoscopic adrenalectomy was twice as much as that of open adrenalectomy previously performed. However, the operation time has been recently shortened to be less than 200 minutes. Hemorrhage during the operation was rather less in laparoscopic surgeries if they were successfully done. Postoperative recovery was found to be much faster and the hospital stay was shortened by more than 10 days in patients operated with a laparoscope. These findings indicate that laparoscopic adrenalectomy is a minimally invasive operation that can increase the QOL's of the patient. Although we consider that this operation may propagate as a method for adrenalectomy in future, it must be performed with a careful backup system in the case of an emergency.