Use of gas-free lateral retroperitoneoscopy from an open mini-approach for adrenalectomy
- Autores: Tsukanov Y.Т1, Tsukanov AY.1
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Afiliações:
- Edição: Nº 2 (2004)
- Páginas: 50-54
- Seção: Articles
- URL: https://journals.eco-vector.com/1728-2985/article/view/275088
- ID: 275088
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Resumo
The aim of the study was assessment of efficacy of gas-free lateral
retroperitoneoscopy from the open miniapproach for adrenalectomy.
Arguments are given for location of the mini-cut in the anterior segment
of the 10th intercostal space and analysis was made of operative
space parameters in retroperitoneoscopy from open mini-approach.
The wound aperture 5.0 cm in size and 15.0 cm in depth is good as
it provides the diameter of the monofocal zone 16.0 cm and bifocal
zone 4.0 cm. If the size of the wound increases to 7.0 cm, the above
parameters rise to 20.0 and 7.9 cm, respectively. Such visualized space
is sufficient for adrenalectomy. Variants of the intervention are proposed
depending on the side and kind of the lesion. A total of 21 patients
with various adrenal pathology were operated. The operation
lasted for 114.7+1.5 min. Overall blood loss reached 22.0±3.2 ml,
transfusion _ 137.811.0 ml. The intestinal function normalized on
day 1-2. In the postoperative period mean number of narcotic analgetics
injections made up 4.9±1.5. Body temperature returned to normal
on day 5.3± 1.6 after the intervention. The length of the scar was
4.210.6 cm. None lethal cases were registered. Conversion to the
classic open procedure had to be made in four cases. Gas-free lateral
retroperitoneoscopic adrenalectomy from open mini-approach is
minimally invasive operation. In well selected cases this is a safe and
effective alternative to conventional and endovideoscopic gas surgery
retroperitoneoscopy from the open miniapproach for adrenalectomy.
Arguments are given for location of the mini-cut in the anterior segment
of the 10th intercostal space and analysis was made of operative
space parameters in retroperitoneoscopy from open mini-approach.
The wound aperture 5.0 cm in size and 15.0 cm in depth is good as
it provides the diameter of the monofocal zone 16.0 cm and bifocal
zone 4.0 cm. If the size of the wound increases to 7.0 cm, the above
parameters rise to 20.0 and 7.9 cm, respectively. Such visualized space
is sufficient for adrenalectomy. Variants of the intervention are proposed
depending on the side and kind of the lesion. A total of 21 patients
with various adrenal pathology were operated. The operation
lasted for 114.7+1.5 min. Overall blood loss reached 22.0±3.2 ml,
transfusion _ 137.811.0 ml. The intestinal function normalized on
day 1-2. In the postoperative period mean number of narcotic analgetics
injections made up 4.9±1.5. Body temperature returned to normal
on day 5.3± 1.6 after the intervention. The length of the scar was
4.210.6 cm. None lethal cases were registered. Conversion to the
classic open procedure had to be made in four cases. Gas-free lateral
retroperitoneoscopic adrenalectomy from open mini-approach is
minimally invasive operation. In well selected cases this is a safe and
effective alternative to conventional and endovideoscopic gas surgery
Bibliografia
- Ипполитов Л. И., Габаидзе Д. И., Ветшев С. Я. Лапароскопическая адреналэктомия. Хирургия 1997; 3: 70-73.
- Petelin J. В. Laparoscopic adrenalectomy. Semin. Laparoscop. urg. - 1996; 2 (2): 84-94.
- Gaur D. D. Retroperitoneal surgery of the kidney, ureter and adenal gland. Endosc. Surg. Allied Technol. 1995; 3 (1): 3-8.
- Давыдов А. А., Баранов Д. В., Крапивин Б. В. и др. осложнения карбоксиперитонеума во время лапароскопическихопераций и их профилактика. Эндоскоп, хир. 2000; 2: 23 -24.
- Седов В. М., Салов А. Б. Факторы риска тромботических сложнений при лапароскопических операциях и их профилактика. Там же. 2001; 2: 55-56.
- Борисов А. Е. (ред.) Видеоэндоскопические вмешательства а органах живота, груди и забрюшинного пространства:руководство для врачей. СПб: Предприятие ЭФА "Янус";2002.
- Уджмаджуридзе Н., Манагадзе Г., Манагадзе Л. Ретропериронеоскопия без использования С02. В кн.: Материалы XРоссийского съезда урологов. М.; 2002. 801-802.
- Богатырев О. П., Каменев А. А. Модифицированный метод дреналэктомии: Метод, рекомендации. М.; 1991.
- Калинин А. П., Куликов Л. К. Хирургические доступы к надпочечникам. Пробл. эндокринол. 2001; 1: 28-29.
- Калинин А. П., Майстренко Н. А. Хирургия надпочечников: уководство для врачей. М.: Медицина; 2000.
- Лопаткин Н. А., Шевцов И. П. Оперативная урология: (Руководство). М.: Медицина; 1996.
- Пытель Ю. А., Золотарев И. И. Неотложная урология. Медицина; 1985.
- Коган А. С., Гончар А. М., Куликов Л. К. Гиперфункция надпочечников: принципы и методы коррекции. Новосибирск: Наука; 1988.
- Морозов А. В. Оперативные доступы при вмешательствах а почке, надпочечнике, верхней и средней трети мочеточника. Урология 2002; 3: 16-20.
- Зильберман М. И., Баев В. А. Ретроперитонеоскопия. Оренбург; 1988.
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