摘要
Abstract
Objective:To explore the method and clinical experience of searching for the central vein by ascending along the gonadal vein in left laparoscopic adrenalectomy via the transabdominal approach.Methods:A retrospective analysis was conducted on the clinical data of 65 patients with left adrenal tumor who were admitted and underwent laparoscopic adrenalectomy via a transabdomi-nal approach between Jan.2,2018 and May 2,2020.Thirty patients(observation group)were treated by tracing the gonadal vein upwards to identify the central vein.During the operation,the gonadal vein was found first,the gonadal vein was traced cranially and dis-sociated to the renal vein,the central vein was identified,ligated,and then divided,and the tumor was removed finally.Thirty-five pa-tients(control group)were treated by directly identifying the central vein and then ligating and dividing it.The time for isolation and disconnection of the central vein,operation time,intraoperative blood loss,postoperative intestinal recovery time,hospitalization time and perioperative complications were compared between the two groups.Results:There were statistically significant differences between the observation group and the control group in the time for isolation and disconnection of the central vein[(25.2±7.1)min vs.(30.1±11.6)min],the operation time[(37.4±8.5)min vs.(42.8±12.2)min],and the intraoperative blood loss[(18.5±10.4)mL vs.(24.5±12.3)mL].The differences were not significant in postoperative intestinal function recovery time([(1.5±0.7)d vs.(1.6±0.6)d]and hospital stay[(14.4±3.0)d vs.(15.9±3.8)d]between the two groups(P＞0.05).The catheter was removed 1-2 d after operation in both groups.In the observation group,there were 20 cases without abdominal drainage tubes,3 cases of gonadal vein laceration were ligated,and 1 case of renal vein injury was sutured.In the control group,there were 12 cases without abdominal drainage tube,2 cases of renal dorsal membrane tear were treated with bipolar electrocoagulation,one patient had a pancreatic tail injury whose drainage tube was placed and removed after full drainage and healing,and one patient developed urinary tract infection and was cured after anti-infection.Conclusions:The central vein can be found by ascending along the gonadal vein in left laparoscopic adrena-lectomy.Primary ligation of the central adrenal vein through this approach is a simple method that can shorten the operation time and be used in clinical practice.关键词
肾上腺肿瘤/肾上腺切除术/腹腔镜检查/生殖静脉/中央静脉Key words
Adrenal gland neoplasms/Adrenalectomy/Laparoscopy/Gonadal vein/Central vein分类
医药卫生
