腹腔鏡下副腎摘除術と開放性手術の手術成績についての比較検討

A comparison of laparoscopic adrenarectomy for adrenal tumor with open surgery

　腹腔鏡下副腎摘除術と開放性手術との比較検討を行った。対象は1997～2006年の片側副腎腫瘍138例で，腹腔鏡下手術が90例，開放性手術が48例であった。開放性手術への転換を6例に認めた。腫瘍径は開放性手術症例が有意に大きかったが，手術時間は同等であった。出血量は，腹腔鏡下手術で有意に少なかった。手術時間と腫瘍径は開放性手術で正の相関がみられた。出血量と腫瘍径は両術式とも相関なく，出血量と手術時間は両術式とも正の相関がみられた。術後の歩行，食事の開始，および退院までの期間は，腹腔鏡下手術症例で有意に短かった。以上より腹腔鏡下副腎摘除術は低侵襲で，術後のQOLが良好な術式といえた。

　We investigated retrospectively the safety and efficacy of laparoscopic surgery for adrenal tumor compared with open surgery. One hundred thirty-eight patients with adrenal tumor received laparoscopic（n＝90）or open（n＝48）surgery in our institute from 1997 to 2006. Six laparoscopic surgery changed to open surgery. The tumor size was larger in open compared with laparoscopic. There was no significant difference in the operation time. The loss of blood was significantly less in laparoscopic compared with open. The tumor size was significantly correlated to the operation time in open but not in laparoscopic. There were no relationships between the tumor size as well as loss of blood in laparoscopic or open. On the other hand,the loss of blood was significantly correlated to the operation time in both surgeries. The patients with laparoscopic surgery were able to walk,eat or leave the hospital earlier than the patients with open. In conclusion,for the treatment of adrenal tumor laparoscopic surgery was less invasive and safer than open.