Nozaki Tetsuo, Kato Tomonori, Morii Akihiro, Fuse Hideki
Department of Urology, Graduate School of Medicine and Pharmaceutical Sciences for Research, University of Toyama, Toyama, Japan.
Curr Urol. 2013 Aug;7(1):40-4. doi: 10.1159/000343553. Epub 2013 Jul 28.
Retroperitoneal neural tumor (RNT) is rarely excised laparoscopically, and the laparoscopic management of RNT remains controversial. We herein report 4 cases of laparoscopic excision of RNT that resulted in diverse clinical outcomes.
Between August 2005 and January 2011, we performed laparoscopic excision of RNT in 4 patients. The mean tumor size was 4.5 cm. The mean operative time was 297 minutes and the mean amount of blood loss was 55 ml. The surgeries were uneventful, with no operative complications or evidence of intra-abdominal bleeding. However, 2 patients required reoperation for delayed hemorrhage and urinoma formation, respectively.
The postoperative pathological diagnoses were schwannoma in 3 patients and ganglioneuroblastoma in 1 patient. All patients were well with no signs of peripheral neuropathy or radiculopathy, and CT and/or (18)F-FDG PET/CT performed during follow-up indicated no evidence of disease.
Obtaining extensive preoperative knowledge of the source neural and vascular anatomy of the tumor is important for the surgical planning of laparoscopic resection of RNT. When a great deal of care is taken to divide the tumor and the source nerves and vital vessels, safe execution of RNT can be achieved for minimal postoperative mortality and morbidity.
腹膜后神经肿瘤（RNT）很少通过腹腔镜切除，RNT的腹腔镜治疗仍存在争议。我们在此报告4例RNT腹腔镜切除术，其临床结果各异。
2005年8月至2011年1月期间，我们对4例患者进行了RNT腹腔镜切除术。肿瘤平均大小为4.5厘米。平均手术时间为297分钟，平均失血量为55毫升。手术过程顺利，无手术并发症或腹腔内出血迹象。然而，2例患者分别因延迟性出血和尿瘤形成需要再次手术。
术后病理诊断为3例施万细胞瘤和1例节细胞神经母细胞瘤。所有患者情况良好，无周围神经病变或神经根病迹象，随访期间进行的CT和/或（18）F-FDG PET/CT检查未发现疾病证据。
术前广泛了解肿瘤的神经和血管解剖来源对于RNT腹腔镜切除术的手术规划很重要。在小心分离肿瘤与神经及重要血管来源时，RNT手术可安全实施，术后死亡率和发病率降至最低。
