探讨经腹腔及经腹膜后两种途径的机器人手术治疗肾上腺腺瘤的安全性及临床疗效。

回顾性分析2017年1月至2018年12月首都医科大学附属北京安贞医院泌尿外科收治的经腹腔途径和经腹膜后途径机器人手术治疗肾上腺腺瘤的39例患者临床资料，其中经腹腔途径16例、经后腹腔途径23例，比较两组患者建立气腹时间、手术时间、术中出血量、术后并发症、平均住院时间及术后住院时间等临床资料，并应用独立样本t检验比较两组的指标差异。

两组的手术时间分别为(142±28)min和(107±26)min，经后腹腔组明显短于经腹腔组(P<0.01)；建立气腹时间分别为(25±6)min和(19±3)min，经后腹腔组明显短于经腹腔组(P<0.01)；术后住院时间分别为(8±2)d和(7±1)d，经后腹腔组明显短于经腹腔组(P＝0.009)；两组的术中出血量、平均住院时间比较，差异无统计学意义(P>0.05)。

对于机器人辅助腹腔镜肾上腺腺瘤切除术，经后腹腔入路较经腹腔入路具有手术时间短、创伤小、术后恢复快等优势。

To explore the safety and clinical efficacy of robot-assisted laparoscopic adrenalectomy retroperitoneum and transperitoneal.

A retrospective analysis was made of the clinical data of 39 patients with adrenal adenoma treated by robotic surgery via retroperitoneal and transperitoneal approaches in Beijing Anzhen Hospital from Jan. 2017 to Dec. 2018. Among them, 16 patients underwent transperitoneal approach and 23 patients underwent retroperitoneal approach. The clinical data of operation time, intraoperative blood lose, hospitalization days and post-operative hospitalization days were compared between the two groups.

The operation time was(142±28)min and(107±26)min, respectively, with statistic differences between retroperitoneal and transperitoneal approach (P<0.01). The establishment of pneumoperitoneum time was(25±6)min and(19±3)min, respectively, with statistic differences between retroperitoneal and transperitoneal approach (P<0.01). The post-operative hospitalization days were(8±2)d and(7±1)d respectively, with statistic differences between retroperitoneal and transperitoneal approach (P=0.009). There were no statistic differences in intraoperative bleeding lose and average hospitalization day between the two groups (P>0.05).

For robot-assisted laparoscopic adrenalectomy, the retroperitoneal approach has the advantages of shorter operation time, less trauma and faster recovery than the transperitoneal approach.