摘要
Abstract
Objective To investigate the technical advantages and clinical value of a modified retro-peritoneoscopic approach via the prerenal fascial plane for adrenalectomy.Methods A retrospective analysis was conducted on 131 patients with adrenal tumors who underwent retroperitoneoscopic adrenalectomy between January 2019 and January 2025.Based on the surgical approach,patients were divided into two groups:The observation group(n=71),who received the modified prerenal fascial plane approach with priority dissection and ligation of the central adrenal vein,and the control group(n=60),who received the conventional"three-layer"technique.The operative time,intraoperative blood loss,postoperative hospital stay,and postoperative complications were compared between the two groups.Results All procedures were successfully completed without conversion to open surgery.The observation group demonstrated significantly shorter operative time,reduced intraoperative blood loss,and shorter postoperative hospital stay compared to the control group,with statistically significant differences(all P＜0.001).Postoperative complications occurred in 4 patients(5.6％)in the observation group(including 2 cases of subcutaneous emphysema and 2 cases of transient hypokalemia)and 8 patients(13.3％)in the control group(including 3 cases of surgical site hematoma,4 cases of paralytic ileus,and 1 case of incisional infection),respectively.No significant difference was found in postoperative complication rates between the two groups(P＞0.05).Follow-up CT scans at 3 months postoperatively revealed no tumor recurrence or surgical site abnormalities in all patients.Conclusions Modified retroperitoneoscopic adrena-lectomy via the prerenal fascial plane approach demonstrates reduced technical difficulty,shorter operative duration,decreased blood loss,and accelerated postoperative recovery.These technical advantages suggest its potential clinical value and warrant consideration for broader application.关键词
肾上腺肿瘤/腹腔镜肾上腺切除术/改良腹膜后入路/肾上腺中央静脉Key words
adrenal neoplasms/laparoscopic adrenalectomy/modified retroperitoneal approach/central adrenal vein
