Retroperitoneoscopic Adrenalectomy for Adrenal Tumors via a Single Large Port
| Autor: | Kiyoki Okada, Daisaku Hirano, Takahiko Hachiya, Toshio Yoshida, Yukie Takimoto, Tadao Saitoh, Sadatsugu Minei, Hajime Ishida, Tetsuo Yoshikawa, Kenya Yamaguchi, Shuji Kiyotaki |
|---|---|
| Rok vydání: | 2005 |
| Předmět: |
Adult
Male medicine.medical_specialty Urology medicine.medical_treatment Adrenal Gland Neoplasms Blood Loss Surgical Axillary lines Balloon Port (medical) Lateral Decubitus Position Humans Medicine Retroperitoneal space Blood Transfusion Retroperitoneal Space Adrenal tumors Aged business.industry Adrenalectomy Middle Aged Surgery Treatment Outcome medicine.anatomical_structure Dilator Female Laparoscopy business |
| Zdroj: | Journal of Endourology. 19:788-792 |
| ISSN: | 1557-900X 0892-7790 |
| DOI: | 10.1089/end.2005.19.788 |
| Popis: | Laparoscopic adrenalectomy is generally performed with carbon dioxide insufflation of the cavity and requires multiple trocars. This study reports the outcomes of retroperitoneoscopic adrenalectomy (RA) for adrenal tumors via a single port using a large cylinder without carbon dioxide insufflation.Fifty-four patients with adrenal tumors were treated using RA via a single large port. The average tumor size was 2.6 cm. For surgery, patients were placed in the lateral decubitus position with slight flexion, and a 4.5-cm skin incision was performed below the 12th rib in the midaxillary line. The retroperitoneal space was dissected using index fingers and a balloon dilator. A rectoscope tube with a 4-cm diameter was inserted, and the adrenal glands were removed endoscopically via the single large port without carbon dioxide insufflation.This procedure was completed in 53 patients (98.1%). The average duration of surgery was 203 minutes, and the mean estimated blood loss was 252 mL. Four patients (7.4%) required blood transfusion. Postoperative major complications, including fulminant hepatitis and pulmonary thrombosis, were observed in two patients (3.7%), and the patient with hepatic disease died on the 14th postoperative day. The mortality rate after surgery thus was 1.9%. However, no local tumor recurrence or hormonal relapse has occurred at a median follow-up of 34 months.This procedure appears to be effective and relatively minimally invasive. However, it is limited by the narrow working space and restriction of the manipulation of instruments. |
| Databáze: | OpenAIRE |
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