腹腔镜处理中腹部原发性腹膜后肿瘤19例.docVIP

腹腔镜处理中腹部原发性腹膜后肿瘤19例【摘要】目的：探讨腹腔镜下经腹腔入路处理中腹部原发性腹膜后肿瘤（PRPT）的可行性。方法：术中经结肠旁沟掀开结肠及其系膜，显露原发性腹膜后肿瘤后完成探查、活检、切除术及放置银夹。结果：19例PRPT均在该术式下完成切除术12例，活检术3例，中转开腹5例，放置银夹3例；手术时间90～210分钟，术中出血30～500 ml，平均190 ml；术后住院5～8天。结论：腹腔镜下处理中腹部原发性腹膜后肿瘤有损伤小、恢复快、手术操作空间大、易暴露等优点，但有出血多、手术时间长的缺点。操作者和助手应有娴熟的腹腔镜下打结和缝合的技术，配备30 L气腹机和超声刀，初学者应选择中腹部非大血管区PRPT，严格掌握手术适应证，仍需经验积累。 【关键词】腹腔镜；处理；中腹部；原发性腹膜后肿瘤 文章编号：1009-5519（2007）11-1610-02 中图分类号：R6 文献标识码：A Laparoscopic management of primary retroperitoneal tumor in the middle of back peritoneum through abdominal cavity:Report of 19 cases LI Zhao-tang1,XU Beng-wen1,ZHANG Zhi-hui1,ZHANG Li-fei1,HUANG Xin-jun1,YAN Shun-xin1,ZHAO Chang-song2 (1.Minisurgical Center of General Department I,The People’s Hospital of Shuyang,Jiangsu 223600,China;2.Chudong Hospital of Xuyi,Jiangsu 211751,China) 【Abstract】Objective:To explore the feasibility of laparoscopic managing the primary retroperitoneal tumor(PRPT) in the middle of back peritoneum through the abdomial cavity.Methods:The PRPT was found by raising the colon from paracolic sulci,the operations including exploration,incisional biopsy,resection and location silver clip were completed perfectly.Results:Nineteen patients were managed in this way.Twelve cases were adopted different methods of resection,3 cases were performed biopsy,2 cases were turned to open operation,3 cases were located with silver clips near the tumor.The operation time was 90 to 210 minutes,the bleeding volume was 30 to 500 ml with an average of 190 ml,the duration of hospitalization was 5 to 8 days.Conclusion:There is good prospect by using this treatment method for following major advantages:small trauma,quick recovery,huge operative room,easy exposition of PRPT and so on,but with shortcomings of much blood losing and long operative time.The main operator and assistants should be equipped with consummate skill on laparoscopic operation,and the air-abdominal machine of 30 litres and supersonic knife should be provided.The primary laparoscopic