血管骨骼化解剖在小儿腹膜后肿瘤切除术中的应用  

Application of vascular skeletal anatomy in children with retroperitoneal tumor resection

作　　者：黎明[1] 李勇[1] 肖雅玲[1] 刘赞 黄召[1] 刘登辉[1] 唐湘莲[1] 周宇翔[1] 向强兴 Li Ming;Li Yong;Xiao Yaling;Liu Zan;Huang Zhao;Liu Denghui;Tang Xianglian;Zhou Yuxiang;Xiang Qiangxing(DepartmentⅡof General Surgery,Hunan Children’s Hospital,Changsha,410007,China)

机构地区：[1]湖南省儿童医院普外二科,湖南省长沙市410007

出　　处：《临床小儿外科杂志》2021年第8期773-777,共5页Journal of Clinical Pediatric Surgery

基　　金：湖南省自然科学基金(编号:2018JJ2210)。

摘　　要：目的探讨血管骨骼化解剖在小儿腹膜后肿瘤切除术中的应用价值,评估其有效性及安全性。方法回顾性收集2018年1月至2019年12月由湖南省儿童医院收治的23例采用血管骨骼化解剖方法行腹膜后肿瘤切除术的患者作为研究对象,收集患者性别、年龄、肿瘤类别及分期、手术方式、肿瘤切除完整程度、手术时间、术中出血量、术后并发症发生率等临床资料。结果23例中,男16例,女7例,年龄3个月至12岁,中位年龄2.8岁。腹膜后神经母细胞瘤15例(包括节细胞神经母细胞瘤、神经节细胞瘤),腹膜后畸胎瘤3例,胰腺实性假乳头状瘤2例,腹膜后淋巴管瘤3例。腹腔镜手术4例,开腹手术19例。所有病例顺利切除肿瘤,肿瘤切除完整度达95%以上,术中无主要血管损伤,无与血管损伤相关的脏器切除。术后并发乳糜瘘2例(8.7%),肾脏萎缩1例(4.3%)。结论血管骨骼化解剖提高了腹膜后肿瘤的切除率,减少了与血管损伤相关的脏器切除或术后脏器萎缩的风险,是一种相对安全有效的术中解剖方法。Objective To explore the application value of vascular skeletal anatomy in children with retroperitoneal tumor resection and evaluate its effectiveness and safety.Methods From January 2018 to December 2019,a total of 23 children underwent retroperitoneal tumor resection through vascular skeletal anatomy.Retrospective analysis was performed for gender,age,tumor type/stage,surgical approach,complete degree of tumor resection,operative duration,intraoperative volume of blood loss and incidence of postoperative complications.Results There were 16 boys and 7 girls with a median age of 2.8(1/4-12)years.There were retroperitoneal neuroblastoma(including ganglioneuroblastoma&gangliocytoma,n=15),retroperitoneal teratoma(n=3),solid pancreatic pseudopapillaryneoplasm(n=2)and retroperitoneal lymphangioma(n=3).Laparoscopy(n=4)and laparotomy(n=19)were performed.In all cases,tumor was successfully removed and the completeness of tumor removal surpassed 95%.There was no major vascular injury and no organ resection related to vascular injury.There were chylous fistula(n=2,8.7%)and renal atrophy(n=1,4.3%).Conclusion Vascular skeletal anatomy improves the resection rate of retroperitoneal tumor and reduces the risk of organ resection or organ atrophy related to vascular injury.It is a relatively safe and effective method of intraoperative anatomy.

关 键 词：腹膜后肿瘤 血管骨骼化 外科手术 儿童 

分 类 号：R735.4[医药卫生—肿瘤] R726.1[医药卫生—临床医学]