基于对右侧肾上腺血管的手术经验总结，探讨后腹腔镜右侧肾上腺切除术中以下腔静脉为解剖标志准确分离出肾上腺动静脉层面的临床可行性及意义。

回顾性分析2020年1月至2021年9月，临沂市人民医院收治的36例右侧肾上腺腺瘤患者，均行后腹腔途径手术，手术由同一名手术医师(高年资主治医师，肾上腺总手术量大于300例)完成，以下腔静脉为解剖标志寻找并处理肾上腺动静脉并切除或部分切除右侧肾上腺。

本组36例手术均顺利完成。平均手术时间32 min，平均术中出血量20 ml，平均下床活动时间为术后16 h，平均术后住院时间2.4 d。

后腹腔镜下右侧肾上腺手术过程中以下腔静脉为解剖标志进行肾上腺血管的解剖分离，可将肾上腺动静脉的前后层次关系安全显露，有利于准确控制中央静脉、更好地显露手术视野和减少术中出血。

To discuss the clinical feasibility and significance of accurately separating the adrenal arteries and veins by using the inferior vena cava as an anatomical landmark in retroperitoneal laparoscopic right adrenalectomy based on the experience in right adrenal surgery.

A retrospective analysis was conducted on 36 patients who have undergone retroperitoneal laparoscopic surgery due to right adrenal tumor in Linyi People′s Hospital from Jan. 2020 to Sep. 2021. Surgeries were performed by the same surgeon who is a senior attending physician and has done more than 300 adrenal surgeries. During the operation, inferior vena cava was used as an anatomical landmark to locate and separate adrenal arteries and veins while performing the entire or partial resection of the right adrenal gland.

All surgeries were successfully completed in 36 cases. The average operative time was 32 min and the mean intraoperative blood loss was 20 ml. The patients were ambulated at 16th h after surgery and the mean postoperative hospital stay was 2.4 d.

Using the inferior vena cava as an anatomical landmark to separate adrenal vessels in retroperitoneal laparoscopic right adrenalectomy helps safely isolate the adrenal arteries and veins according to anatomical relationships and accurately locate the central vein, which can improve visibility in the surgical field and reduce intraoperative blood loss.