后腹腔镜下腹膜后神经鞘瘤切除术27例报告  

Laparoscopic resection of retroperitoneal neurilemmoma(Report of 27 cases)

作　　者：白亚飞[1] 武玉东[1] 程传宇[1] 张雪培[1] 高建光[1] 

机构地区：[1]郑州大学第一附属医院泌尿外科,郑州450052

出　　处：《临床泌尿外科杂志》2008年第10期733-734,737,共3页Journal of Clinical Urology

摘　　要：目的:应用后腹腔镜技术治疗腹膜后神经鞘瘤,探讨其安全性和可行性。方法:本组27例患者均经腹膜后途径腹腔镜下切除腹膜后神经鞘瘤。B超检查偶然发现18例、血压升高4例、腰腹部酸疼5例。血肾上腺素、去甲肾上腺素升高1例。27例均行B超及CT检查,其中22例同时行MRI检查。肿瘤位于左侧肾上腺周围9例、右侧肾上腺周围7例、左肾下极2例、右肾下极2例、腹主动脉旁2例、下腔静脉旁5例。结果:其中26例获得成功,肿瘤直径1.5～5.0cm,平均3.4cm;手术时间45～105min,平均60min;出血量15～110ml,平均65ml。腹膜损伤1例,中转开放手术,无后遗症。无损伤大血管及大出血及膈肌损伤病例,无输血病例。结论:后腹腔镜下切除腹膜后神经鞘瘤,手术出血少、创伤小、患者恢复快,在选择合适病例的前提下,是切除腹膜后神经鞘瘤的一种较好方法。Objective： To report the initial experience of laparoscopic resection of retroperitoneal neurilemmoma. Methods： Twenty-six retroperitoneal neurilemmoma locating underwent retroperitoneal laparoscopic resection; one opemtion was converted to open way as the peritoneum was penetmted largely and recovered without sequelae. The neurilemmoma was located in left adrenal area （n = 9）, right adrenal （n = 7）, left renal under （n = 2）, right renal under （n=1）, beside aorta （n=2）, beside postcava （n=5） respectively. Results： There were no conversions or blood tmnsfusion. Twenty-six retroperitoneal neurilemmoma in tmnsperitoneal way, the avemge opemtive time was 60min（45-105min）, the avemge tumor size was 3.2cm（1.5-5.0 cm）, the estimated bleeding volume was 65 ml（15-110ml）, and the patients were discharged 4-7d after opemtion. The injury of large blood vessel and diaphmgma and blood tmnsfusion were not happened. Conclusions：Laparoscopic resection of retro-peritoneal neurilemmoma offers a new effective and minimally invasive treatment, and minimal bleeding and recovered quickly, Laparoscopic resection of retroperitoneal neurilemmoma might be better method.

关 键 词：后腹腔镜 神经鞘瘤 腹膜后 

分 类 号：R737.7[医药卫生—肿瘤]