Feasibility and safety of robotic-assisted laparoscopic adrenalectomy with the assistance of three-dimensional reconstruction of computed tomography image to treat huge adrenal tumors
10.3760/cma.j.cn112330-20210408-00176
- VernacularTitle:CT三维重建辅助下机器人肾上腺切除术治疗肾上腺巨大肿瘤的可行性和安全性
- Author:
Heng LI
1
;
Jun YANG
;
Fan LI
;
Yuchao LU
;
Chunguang YANG
;
Xing ZENG
;
Zheng LIU
;
Zhihua WANG
;
Wei GUAN
;
Xiao YU
;
Zhiquan HU
;
Shaogang WANG
Author Information
1. 华中科技大学同济医学院附属同济医院泌尿外科，武汉 430030
- Keywords:
Adrenal gland neoplasms;
Robot-assisted laparoscopic adrenalectomy;
Large adrenal tumors;
Three-dimensional image
- From:
Chinese Journal of Urology
2023;44(12):897-900
- CountryChina
- Language:Chinese
-
Abstract:
Objective:Efficacy and safety of robot-assisted laparoscopic adrenalectomy as a treatment for large adrenal tumors.Three-dimensional(3D) reconstruction can effectively assist in preoperative planning of robotic adrenalectomy and reduce potential complications.Methods:We retrospectively reviewed the relevant information of patients who had a preoperative 3D reconstruction and underwent RA for adrenal masses larger than 10 cm. Thirteen male patients and sixteen female patients were included. The median(range) age was 43(25, 57) years old and the median tumor diameter was 12.1(10.3, 16.2) cm. The patients underwent preoperative CT enhancement scanning, and three-dimensional images were reconstructed based on the examination data. Robot-assisted laparoscopic adrenalectomy was performed under general anesthesia in 29 cases in this cohort.Results:All surgeries were completed successfully without major complications such as massive bleeding, secondary surgery, or even patient death. The median operative time was 131 (80, 245) min, and the median intraoperative bleeding was 330 (50, 2 200 ml) ml. 9 patients received blood transfusions. There were 11 cases of pheochromocytoma (37.9%), 10 cases of adenocarcinoma (34.5%) as well as 2 cases of teratoma (6.9%) and 6 cases of cortical carcinoma (20.7%). The patients were followed up for a median of 30 months after surgery. Except for 3 cases lost to follow-up and 2 patients with cortical cancer who developed recurrence or metastasis after surgery and died at 16 and 23 months after surgery, respectively, the remaining 24 cases have survived to date.Conclusions:RA is a safe and effective treatment for huge adrenal tumors. The 3D reconstruction could help the preoperative planning of RA and reduce potential complications.
