10 cm以上の副腎腫瘍 (骨髄脂肪腫, chronic expanding hematoma, 褐色細胞腫) に対する鏡視下手術の検討

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  • 白石 晃司
    山口大学大学院医学系研究科泌尿器科学講座
  • 磯山 直仁
    山口大学大学院医学系研究科泌尿器科学講座
  • 矢野 誠司
    山口大学大学院医学系研究科泌尿器科学講座 現 : 益田赤十字病院泌尿器科
  • 松山 豪泰
    山口大学大学院医学系研究科泌尿器科学講座

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Abstract

<p>Purpose: With our experience of surgery for adrenal tumors with diameter larger than 10 cm and feasibility and limitations of laparoscopic resection was discussed.</p><p>Case presentations: 1) 56 years old, male, pheochromocytoma (right, 10 cm), retroperitoneoscopy, 2) 63 years old, male, myelolipoma (right, 10 cm), retroperitoneoscopy, 3) 68 years old, male, chronic expanding hematoma (left, 18 cm), retroperitoneoscopy with hand-assisted approach 4) 51 years old, male, pheochromocytoma (left, 17 cm), retroperitoneoscopy with lumbar oblique incision. No recurrence was observed for pheochromocytoma.</p><p>Conclusion: Early transection of feeding artery caused shrinkage of tumor, less blood loss and facilitated retroperitoneoscoic resection for three cases. On the other hand, increased blood loss was observed after open conversion for two cases, which may be caused by incomplete hemostat during pneumoperitonem. These observations need further discussions for surgical approach against giant adrenal tumors.</p>

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