小儿腹腔镜下腹膜后肿物切除术14例报告

发布时间：2018-05-09 19:19

本文选题：腹腔镜 + 腹膜后肿瘤　；参考：《中国微创外科杂志》2017年09期

【摘要】：目的探讨小儿腹腔镜下腹膜后肿物切除术的安全性和有效性。方法 2009年8月~2016年5月对14例小儿腹膜后肿物采用腹腔镜手术切除,其中右上腹膜后肿物采用悬吊肝右叶暴露肿瘤的方法,用Hem-o-lok夹闭肿瘤动脉和静脉分支,断离血管后将肿物完整切除;左上腹膜后肿物,将结肠韧带游离,脾脏和胰腺掀起,暴露肿瘤,用Hem-o-lok夹闭肿瘤动脉和静脉分支后切除肿瘤。1例右侧髂血管表面肿瘤,将肿物与髂静脉分离后完整切除。1例左侧结肠旁沟内囊性肿物,沿边界将肿物完整切除。结果 12例成功完成腹腔镜腹膜后肿物切除术,2例中转开腹手术。手术时间60~230 min,平均126 min;术中出血量10~100 ml,平均41 ml,无输血者。术后住院时间1~7 d,平均4 d。术后病理:节细胞神经母细胞瘤5例,成熟性畸胎瘤3例,肾上腺囊肿2例,囊性淋巴管瘤1例,囊性肉芽肿1例,消化道畸形1例,节细胞胶质瘤1例。14例随访1~82个月(中位数32.5月),未见复发。结论腹腔镜腹膜后肿物切除术是治疗腹膜后肿瘤安全而有效的方法。
[Abstract]:Objective to evaluate the safety and efficacy of laparoscopic retroperitoneal mass resection in children. Methods from August 2009 to May 2016, 14 cases of retroperitoneal tumor in children were resected by laparoscopy. The right epigastric retroperitoneal tumor was exposed by hanging right lobe of liver, and the branches of tumor artery and vein were occluded by Hem-o-lok. The left epigastric tumor was removed completely, the colon ligament was free, the spleen and pancreas were lifted up, the tumor was exposed, and the tumor was removed with Hem-o-lok after the tumor artery and vein branches were clipped, and the tumor was removed from the surface of the right iliac blood vessel with Hem-o-lok, and the tumor was removed from the left epigastric peritoneum. After separating the tumor from the iliac vein, the cystic mass in the left paracolon sulcus was removed completely, and the tumor was removed completely along the boundary. Results Laparoscopic retroperitoneal mass resection was successfully performed in 12 cases. The operative time was 60 ~ 230 min with an average of 126 min, and the intraoperative bleeding volume was 10 ~ 100 ml (mean 41 ml). Postoperative hospitalization time was 1 ~ 7 days (mean 4 days). Postoperative pathology: ganglioneuroblastoma (5 cases), mature teratoma (3 cases), adrenal cyst (2 cases), cystic lymphangioma (1 case), cystic granuloma (1 case), alimentary tract malformation (1 case). One case with ganglion cell glioma. 14 cases were followed up for 1 ~ 82 months (median 32.5 months), no recurrence was found. Conclusion Laparoscopic retroperitoneal tumor resection is a safe and effective method for the treatment of retroperitoneal tumor.
【作者单位】：首都儿科研究所普外科;
【基金】：北京市自然科学基金(7164242) 北京市属医院科研培育项目(PX2016003) 首都卫生发展科研专项(首发2016-4-2104)
【分类号】：R735.4

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