Târcoveanu Eugen, Moldovanu Radu, Bradea Costel, Vlad Nutu, Ciobanu Delia, Vasilescu Alin
Chirurgia (Bucur). 2016 May-Jun;111(3):236-41.
The abdominal cystic lymphangioma (CL) in adults is a rare benign tumor of the lymphatic system.
We report a retrospective study from January 2002 to Decemberr 2014 concerning 18 patients who underwent surgical removal of a CL, 9 patients with laparoscopic approach included. The localization, size, and number, diagnostic, treatment and results have been reported for patients approached laparoscopically.
There were 8 women and 1 man with median age at diagnosis was 35,6 years (range 20-51 years). Clinically, the main symptom was an abdominal pain found in 8 patients (88.8%). Physical examination revealed an abdominal mass in 5 patients (55.5%). The CL was asymptomatic in four patients; the discovery of CL was performed preoperatively during an ultrasound for another pathology (n=3) or intraoperatively (n=1). US exam CT scan usually allow the preoperative diagnosis. The most common site was shared equally between the mesentery (n = 3; 33%) and left retroperitoneum (n = 3;33%), followed by the right retroperitoneum and the posterior cavity of the lesser omentum and great omentum, each one case. The most common procedures performed were: laparoscopic total cystectomy of a closed cyst in two patients and evacuation of larger cysts followed by total cystectomy in seven patients. No conversion, no mortalities and no morbidity was noted. Mean hospital stay was 3.4 days. No recidive after 28 months in the average after treatment.
The laparoscopic approach is the gold standard in the treatment of intraabdominal CL.We recommend complete surgical excision to avoid recurrence.
成人腹部囊性淋巴管瘤(CL)是一种罕见的淋巴系统良性肿瘤。
我们报告了一项回顾性研究,时间跨度为2002年1月至2014年12月,涉及18例行CL手术切除的患者,其中9例采用腹腔镜手术。报告了接受腹腔镜手术患者的病变部位、大小、数量、诊断、治疗及结果。
患者共8名女性和1名男性,诊断时的中位年龄为35.6岁(范围20 - 51岁)。临床上,主要症状为腹痛,8例患者(88.8%)出现该症状。体格检查发现5例患者(55.5%)有腹部肿块。4例患者的CL无症状;3例患者在术前因其他病理情况行超声检查时发现CL,1例在术中发现。超声检查和CT扫描通常可实现术前诊断。最常见的部位是肠系膜(n = 3;33%)和左腹膜后间隙(n = 3;33%),二者相同,其次是右腹膜后间隙以及小网膜和大网膜后腔,各1例。最常实施的手术操作是:2例患者行腹腔镜下闭合性囊肿全切除术,7例患者先排空较大囊肿,随后行全切除术。未出现中转开腹、死亡及并发症。平均住院时间为3.4天。治疗后平均28个月无复发。
腹腔镜手术是治疗腹腔内CL的金标准。我们建议完整手术切除以避免复发。