Research On The Application Of Single Plane Separation In Retroperitoneal Laparoscopic Adrenal Surgery

Objective:Comparing the safety and effectiveness of the single plane separation and the anatomical plane separation in retroperitoneal laparoscopic adrenal surgery to provide a basis for the rational selection of the adrenal gland separation method in clinical surgery.Methods:Retrospective analysis was performed on the data of 226 patients who underwent retroperitoneal laparoscopic adrenal surgery in our department from January 2017 to January 2019.According to the different methods of separating the adrenal gland,the patients were divided into the single plane group and the anatomical plane group.131 cases were in the single plane group and 95 cases were in the anatomical plane group.Compare the age,lesion site,tumor diameter,operation time,intraoperative blood loss,postoperative indwelling catheter time,intraoperative and postoperative complications,postoperative drainage volume,postoperative indwelling drainage tube time,postoperative hospital day,hospital cost and postoperative pathology of patients in the two groups,to evaluate the safety and effectiveness of single plane separation in retroperitoneal laparoscopic adrenal surgery.Results:The operations of 226 patients were completed successfully,and none of them changed to open operation halfway.There were 131 cases in the single plane group,including 73 cases on the left,58 cases on the right,46 cases were males and 85 cases were females.There were 95 cases in the anatomic plane group,including 52 cases on the left,43 cases on the right,33 cases were males and 62 cases were females.The average ages of patients in the two groups were 51.47±11.41 years old and51.82±10.83 years old,the diameters of adrenal tumors were respectively2.2± 1.0cm and 2.1±1.1cm.The mean operation time was 55.65±12.30 min and 99.95±38.94 min,the postoperative indwelling catheter time was1.63±0.67 d and 1.85±0.62 d.The postoperative drainage volume of the patients in the two groups was 39.64±32.32 ml and 71.16±65.81 ml,and the time of postoperative indwelling drainage tube was 2.35±0.75 d and3±0.74 d.The postoperative hospital days were 3.18±0.88 d and3.71±0.86 d,the hospital costs were 21859.14±2843.91 yuan and23767.6±3192.19 yuan.The amount of intraoperative blood loss in both groups was small and could not be accurately counted.There were no intraoperative and postoperative complications in both groups.By comparison and analysis,there was no statistical difference in the age,gender,lesion site,tumor size,and postoperative pathology of the patients in the two groups(P > 0.05).The operation time,postoperative indwelling catheter time,postoperative drainage volume and indwelling drainage tube time,postoperative hospital day and hospital cost of the patients in the anatomical plane group were higher than that in the single plane group,and there was statistical difference(P < 0.05).Conclusion:Both single plane retroperitoneal laparoscopic adrenal surgery and retroperitoneal laparoscopic anatomic adrenal surgery are safe and effective,however single plane separation has the advantages of short operation time,quick postoperative recovery and low hospital cost,which is worthy of clinical application and promotion.