腔镜在小儿肿瘤治疗中的应用研究  

Application of endoscopy in the treatment of children with cancer

作　　者：吴宙光[1] 王斌[1] 陈子民[1] 冯奇[1] 王建尧[1] 刘冬[1] Wu Zhouguang;Wang Bin;Chen Zimin;Feng Qi;Wang Jianyao;Liu Dong(Department of General Surgery,Shenzhen Children's Hospital,Shenzhen,Guangdong,518026,China)

机构地区：[1]深圳市儿童医院普外科

出　　处：《当代医学》2019年第28期8-11,共4页Contemporary Medicine

基　　金：2017年度国家自然科学基金资助项目(81770512);2018年度深圳市卫计委“三名工程”资助项目(SZSM201812055)

摘　　要：目的探讨腔镜技术治疗小儿肿瘤的安全性、有效性及可行性。方法选取本院2015年1月至2018年1月对168例经B超、CT等手段检查证实诊断为小儿肿瘤的患者,年龄1个月~16岁,肿瘤直径2~22 cm,良性肿瘤及囊性肿瘤大小不受限制,恶性肿瘤直径<5 cm,所有患儿均采用腔镜治疗。其中良性肿瘤共128例,其中卵巢囊肿12例,肾上腺腺瘤5例,纵隔肿瘤3例,肾囊肿3例,腹腔畸胎瘤32例,肠系膜囊肿22例,大网膜囊肿42例,腹膜后巨大囊肿5例,胰腺囊肿3例,胰腺胰岛素瘤1例。恶性肿瘤共40例,其中肺转移肿瘤3例,腹腔恶性畸胎瘤21例,腹部神经母细胞瘤6例,肾母细胞瘤4例,肝母细胞瘤4例,纵隔恶性畸胎瘤2例。所纳入研究患儿均行肿瘤腔镜切除术,对恶性肿瘤采取根治切除,对良性肿瘤实施完整切除。结果所纳入研究患儿手术均顺利完成,中转开放手术4例。手术时间为(183.5±45.2)min,出血量为(62.3±22.5)ml,术后住院时间为(12.2±5.1)d,术后无并发症发生,无围手术期死亡。术后随访6~36个月,良性肿瘤患儿均健康生存,无复发,恶性肿瘤患儿中36例健康生存,4例出现肺转移,在6~12个月死亡。结论应用腔镜手术是治疗小儿良恶性肿瘤有效、安全的方法,近期随访效果满意。Objective To investigate the endoscopic treatment of pediatric tumors of safety,efficacy and feasibility.Methods From January 2015 to January 2018,46 patients with B ultrasound,CT examination confirmed the diagnosis of other means to pediatric oncology patients,aged 1 month to 16 years,tumor diameter 2-22 cm,benign tumors and bladder tumor size is not limited,malignant diameter<5 cm,all patients were using endoscopic treatment.Among them,there were 128 cases of benign tumors,including 12 ovarian cysts,5 adrenal adenomas,3 mediastinal tumors,3 renal cysts,32 abdominal teratoma,22 mesenteric cysts,42 greater omentum cysts,5 retroperitoneal cysts,3 pancreatic cysts and 1 pancreatic insulinoma.There were 40 cases of malignant tumor,including 3 cases of pulmonary metastases,21 cases of malignant abdominal teratoma,6 cases of abdominal neuroblastoma,4 cases of nephroblastoma,4 cases of hepatblastoma,and 2 cases of mediastinal teratoma.All the children in the study underwent endoscopic resection of tumor,radical resection of malignant tumor and complete resection of benign tumor.Results The operations were successfully completed and 4 cases were converted to open surgery.The operation time was(183.5±45.2)minutes,the bleeding volume was(62.3±22.5)ml,and the postoperative hospitalization time was(12.2±5.1)days.There was no postoperative complications and no death in the perioperative period.After follow-up,all the children with benign tumor were healthy and had no recurrence.36 of the children with malignant tumor were healthy,4 had pulmonary metastasis and died in 6-12 months.Conclusion Endoscopic surgery is an effective and safe method for the treatment of benign and malignant neoplasms in children.The short-term follow-up results are satisfactory.

关 键 词：小儿肿瘤 腔镜 微创技术 良性肿瘤 恶性肿瘤 

分 类 号：R73[医药卫生—肿瘤]