肾前筋膜间平面在层面外科解剖性后腹腔镜肾上腺手术的应用

【摘要】 目的 探讨肾前筋膜间平面在层面外科解剖性后腹腔镜肾上腺手术中应用的可行性与安全性。方法 选取2023年6月至2025年6月肾上腺肿瘤患者60例，随机分为观察组（30例）与对照组（30例）。观察组应用肾前筋膜间平面层面外科解剖性后腹腔镜肾上腺切除术，对照组应用传统经腹腹腔镜肾上腺切除术。比较两组患者手术时间、术中出血量、术后第1天引流液量、术后首次进食时间、肛门排气时间、术后拔管时间、应激反应指标（血白细胞、空腹血糖）及并发症发生率。结果 观察组中术中出血量、术后第1天引流液量少于对照组，手术时间、肛门排气时间、首次进食时间及引流管拔出时间短于对照组，差异有统计学意义（P<0.05）。两组术后血白细胞、空腹血糖及并发症发生率比较，差异无统计学意义（P>0.05）。结论 应用肾前筋膜间平面的层面外科解剖性后腹腔镜肾上腺手术是一种安全可行的手术方式，肾前筋膜间平面是肾上腺手术重要的解剖平面。更多还原

【Abstract】 Objective To investigate the feasibility and safety of the interfascial plane of the anterior renal fascia in laminar surgery laparoscopic anatomical adrenalectomy. Methods Sixty patients with adrenal tumors admitted to our hospital from June 2023 to June 2025 were randomly divided into observation group(30 cases)and control group(30 cases). The observation group underwent laminar surgery laparoscopic anatomical adrenalectomy via the interfascial plane of the anterior renal fascia, while the control group underwent traditional transperitoneal laparoscopic adrenalectomy. The operation time, intraoperative blood loss, drainage volume on the first postoperative day, first postoperative feeding time, anal exhaust time, postoperative drainage tube removal time, stress response indicators(blood white blood cells, fasting blood glucose)and complication rate were compared between the two groups. Results The operation time, intraoperative blood loss, drainage volume on the first postoperative day in the observation group were less than those in the control group, and the anal exhaust time, first feeding time and drainage tube removal time were shorter than those in the control group. The differences were statistically significant(P<0.05). However, there were no statistically significant differences in postoperative white blood cell(WBC) and fasting plasma glucose(FPG) levels and complication rate between the two groups(P>0.05). Conclusion The application of the interfascial plane of the anterior renal fascia in laminar surgery laparoscopic anatomical adrenalectomy is a safe and feasible surgical method, and the interfascial plane of the anterior renal fascia is an important anatomical plane for adrenal surgery.更多还原