肾上腺肿瘤的外科治疗:喀麦隆雅温得三所三级医院的经验

Junior Barthelemy Mekeme Mekeme, Etoa Ndzie, Agbor Orock Tanyi, Jean Cedrick Fouda, Achille Aurele Mbassi, Philip Owon Abessolo, Bright Che Awondo, Marcel Junior Yon Mekeme, Pierre Ongolo Zogo, Pierre Joseph Fouda, Eugene Sobngwi, Zachary Sando, Angwafo III Fru
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摘要

在过去的几年里,肾上腺肿瘤的手术治疗有了很大的改善,腹腔镜肾上腺切除术是金标准。然而,开放肾上腺切除术适用于大肾上腺肿瘤、恶性肿瘤和大嗜铬细胞瘤。我们报告了从2007年到2022年18例功能性肾上腺肿瘤的手术结果。方法:我们在喀麦隆雅温得的三家三级医院进行了回顾性横断面和描述性研究。我们回顾了2007年7月至2022年7月15年间接受肾上腺切除术的患者档案。分析肾上腺肿瘤的临床和诊断成分、适应证和手术结果。结果:本研究共纳入18例患者。患者平均年龄38.33岁,男女性别比2:1。体重增加(72.2%)是最具代表性的临床症状。分泌性肿瘤和恶性肿瘤分别占手术指征的55.5%和33.3%,18例(100%)患者均行开放性肾上腺切除术。血管损伤是最常见的术中并发症(5.63%),急性肾上腺功能不全是最常见的术后并发症(16.7%)。肿瘤平均大小为6.22 cm,平均住院时间为11.61 d。腺瘤7(38.9%)和肾上腺皮质癌5(27.8%)是常见的组织学类型。一名患者在术后两个月死于贫血相关并发症。结论:肾上腺外科手术的成功与多学科的患者护理和外科医生的经验有关。在我们的背景下,传统手术仍然具有令人满意的短期和中期结果的适应症。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Surgical Management of Adrenal Tumors: Experience of Three Tertiary Hospitals in Yaounde, Cameroon
Introduction: Surgical management of adrenal tumors has greatly improved over the past years, with laparoscopic adrenalectomy being the gold standard. However, Open adrenalectomy is indicated in large adrenal tumors, malignant tumors and large phaeochromocytomas. We report surgical outcomes of 18 cases of functional adrenal tumors from 2007 to 2022. Methods: We conducted a retrospective cross-sectional and descriptive study in three tertiary hospitals in Yaounde, Cameroon. We reviewed files of patients who underwent adrenalectomy over a period of 15 years from July 2007 to July 2022. Clinical and diagnostic components of adrenal tumors, indications and surgical outcomes were analyzed. Results: A total of 18 patients were included in our study. The average age of patients was 38.33 years, with a female-to-male sex ratio of 2:1. Weight gain (72.2%) was the most represented clinical sign. The secretory nature of tumor and malignancy represented 55.5% and 33.3% of the operative indications and all 18 (100%) of the patients had open adrenalectomy. Vascular injury was the most common intraoperative complication with 5.63%, while acute adrenal insufficiency (16.7%) was the most common post-operative complication. The average tumor size was 6.22 cm and the mean duration of hospitalization was 11.61 days. Adenoma 7 (38.9%) and adrenocortical carcinoma 5 (27.8%) were the frequent histological types. One patient died two months post-surgery from anemia-related complications. Conclusion: The success of adrenal surgery is linked to multidisciplinary patient care and the experience of the surgeon. Conventional surgery still has indications with satisfactory short- and medium-term results in our context.
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