经外侧腹膜后入路显微手术治疗腰椎椎旁肿瘤  

Microsurgical treatment of lumbar paravertebral tumors via lateral retroperitoneal approach

作　　者：陈世超 王凯 王作伟[2] 吴浩[2] Chen Shichao;Wang Kai;Wang Zuowei;Wu Hao(Department of Neurosurgery,Beijing Ditan Hospital Affiliated to Capital Medical University,Beijing 100015,China;Neurospinal Center,Xuanwu Hospital of Capital Medical University,Beijing 100530,China)

机构地区：[1]首都医科大学附属北京地坛医院神经外科,北京100015 [2]首都医科大学宣武医院神经脊柱中心,北京100530

出　　处：《中华脑科疾病与康复杂志（电子版）》2021年第6期366-369,共4页Chinese Journal of Brain Diseases and Rehabilitation（Electronic Edition）

摘　　要：目的探讨经外侧腹膜后入路显微手术治疗腰椎椎旁肿瘤的技术特点及治疗效果。方法回顾性分析首都医科大学宣武医院神经脊柱中心自2019年6月至2020年12月经外侧腹膜后入路手术治疗的6例腰椎椎旁肿瘤患者的临床资料,统计患者手术时间、出血量、切口长度、住院时间、占位切除率、日常生活能力(ADL)评分及术后并发症情况。结果本组患者手术时间范围56~181 min,出血量范围5~100 mL,手术切口长度范围6~7 cm,住院时间范围5~11 d。椎旁肿瘤切除率100%。术后病理诊断神经鞘瘤4例,节细胞神经瘤1例,小圆细胞恶性肿瘤1例。随访3个月,肿瘤无复发,无腹腔感染及切口感染,无切口疝,无死亡病例,ADL评分较术前无明显减低。结论经外侧腹膜后入路手术治疗腰椎椎旁肿瘤具有手术时间短、微创、恢复快、并发症少等特点,值得临床推广。Objective To investigate the technical characteristics and therapeutic effect of lateral retroperitoneal microsurgery in the treatment of lumbar paravertebral tumors.Methods The clinical data of 6 cases of lumbar paravertebral tumors surgery through lateral retroperitoneal approach in the Neurospinal Center of Xuanwu Hospital of Capital Medical University from June 2019 to December 2020 were retrospectively analyzed.The average operation time,blood loss,Incision length,resection rate,length of hospital stay,activities of daily living(ADL)score and postoperative complications were analyzed.Results The operation time ranged from 56 to 181 min,the amount of bleeding ranged from 5 to 100 mL,the length of surgical incision ranged from 6 to 7 cm,and the hospital stay ranged from 5 to 11 d.The resection rate of paravertebral tumor was 100%.Postoperative pathological diagnosis included schwannoma in 4 cases,ganglioneuroma in 1 case and small round cell malignant tumor in 1 case.After 3 months of follow-up,there was no recurrence,no abdominal infection,no incision infection,no incisional hernia,no death,and no significant decrease in ADL score.Conclusion The lateral retroperitoneal approach in the treatment of lumbar paravertebral tumors has the characteristics of short operation time,minimally invasive,rapid recovery and few complications,which is worthy of clinical promotion.

关 键 词：外侧腹膜后入路 腰椎椎旁占位 显微手术 

分 类 号：R738.1[医药卫生—肿瘤]