Lacarriere Emeric, Le Long Erwann, Caremel Romain, Grise Phillippe
Department of Urology, Rouen University Hospital, Rouen, France.
J Laparoendosc Adv Surg Tech A. 2012 Apr;22(3):269-72. doi: 10.1089/lap.2011.0407. Epub 2012 Feb 15.
Schwannomas are rare tumors and are exceptionally retroperitoneal. In the event of clinical signs or uncertainty in the diagnosis, their removal is justified. A risk of neoplastic transformation exists.
Three patients had a retroperitoneal schwannoma located next to or under the sacral promontory. A double approach using an initial retroperitoneoscopy and an iliac abdominal incision had been decided preoperatively. This approach has not been described previously in the medical literature.
The double approach enabled the complete removal of tumors in all patients. The iliac incision, described within, enabled the removal of the tumors despite major attachments and difficulties in exposure, due to the tumors' distal situations.
A double approach by retroperitoneoscopy and laparotomy can enable removal of difficult low-seated retroperitoneal schwannomas without increasing intraoperative risk or perioperative morbidity.
施万细胞瘤是罕见肿瘤，尤其好发于腹膜后。出现临床症状或诊断存疑时，切除肿瘤是合理的。存在肿瘤恶变风险。
3例患者的腹膜后施万细胞瘤位于骶岬旁或其下方。术前决定采用先经后腹腔镜检查再经髂腹部切口的双入路方法。此前医学文献中未描述过这种方法。
双入路方法使所有患者的肿瘤得以完整切除。文中描述的髂腹部切口，尽管肿瘤位置靠下，有主要附着点且暴露困难，但仍能切除肿瘤。
经后腹腔镜检查和剖腹术的双入路方法能够切除位置较低、手术困难的腹膜后施万细胞瘤，且不增加术中风险或围手术期发病率。
