後腹膜腔鏡下副腎摘除術の検討—当院での手術手技と成績

Clinical Study of Retroperitoneoscopic Adrenalectomy: Surgical Procedure and the Results

　副腎腫瘍に対する後腹膜腔鏡下副腎摘除術を11例経験した．1例が経腹膜到達法に移行したが，開放手術となった症例はなかった．手術時間は平均180分，出血量は平均58ml．術後合併症として1例に膵液瘻を認め，これはハーモニック　スカルペル（LCS）による膵損傷が原因と考えられた．合併症のない10例では翌日から歩行および食事を開始し，ドレーンも術後1〜2日で抜去可能で，術後在院日数は平均6日であった．開放手術10例と比較すると手術時間は長いが，出血量，ドレーン抜去時期，術後在院日数は内視鏡下手術のほうが有利であり，低侵襲で美容上も優れているため，後腹膜腔鏡下副腎摘除術は副腎腫瘍に対し有用な手技である．

Retroperitoneoscopic adrenalectomy was performed on eleven cases during the recent 16 months at our hos-pital. In one patient, surgical procedure was converted to transperitoneal approach. However, open method was not required in any of the patients. Mean operating time and average blood loss were 180minutes and 58ml, re-spectively. A minor leakage of pancreatic juice which was caused by LCS was identified in one patient postoperatively. The other 10 patients without complication were up and about smoothly and dietary uptake was commenced on the 1st postoperative day.