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目的探讨腹腔镜下切除原发性腹膜后肿瘤的安全性及手术效果。方法回顾性分析2006年1月至2015年12月期间于北京大学第三医院普通外科接受腹腔镜切除手术的52例原发性腹膜后肿瘤患者的临床资料。结果 52例患者中,21例患者(40.3%)的肿瘤与大血管关系密切,31例患者(59.7%)的肿瘤远离大血管。2例(3.8%)早期病例在手助下完成,2例(3.8%)因肿瘤与大血管粘连致密中转开腹手术。平均手术时间为171.4 min(60~520 min);平均切口长度为2.8 cm(1~15 cm);术中平均出血量为86.4 mL(10~1 150 mL),其中2例输血;术后平均饮食恢复时间为1.5 d(1~5 d);术后平均住院时间为4.9 d(1~16 d)。围手术期均无严重并发症及死亡病例。术后47例获访,平均随访时间为62个月(4~120个月)。随访期间,3例腹膜后脂肪肉瘤患者复发,1例黏液性外周神经鞘瘤患者复发,均行再次手术切除,余无复发及转移病例;非肿瘤相关死亡3例。结论腹腔镜下能够安全地切除毗邻腹腔大血管的原发性腹膜后肿瘤。
Objective To investigate the safety and operative effect of laparoscopic resection of primary retroperitoneal tumor. Methods The clinical data of 52 patients with primary retroperitoneal tumor undergoing laparoscopic surgery in General Surgery, Peking University Third Hospital from January 2006 to December 2015 were retrospectively analyzed. Results Among the 52 patients, tumors in 21 patients (40.3%) were closely related to the great vessels, and tumors in 31 patients (59.7%) were far away from the major vessels. Two cases (3.8%) of the early cases were performed with the help of hand, and two (3.8%) patients underwent open laparotomy due to tight tumor and large vessel adhesions. The mean operative time was 171.4 min (60-520 min). The average incision length was 2.8 cm (1-15 cm). The average intraoperative blood loss was 86.4 mL (10-1 150 mL) The diet recovery time was 1.5 days (1-5 days). The average postoperative hospital stay was 4.9 days (1-16 days). Perioperative no serious complications and deaths. Forty-seven patients were followed up for an average of 62 months (range 4 to 120 months). During the follow-up period, 3 cases of retroperitoneal liposarcoma recurred, and 1 case of mucinous peripheral schwannoma recurred. All patients underwent resection and no recurrence and metastasis. Three cases were non-tumor related. Conclusions Laparoscopic resection of the primary retroperitoneal tumor adjacent to the large peritoneal cavity can be safely performed.