Liu Tao, Chen Kun, Xia Rong-Mu, Li Wen-Gang
Department of Hepatobiliary Surgery, Xiang'an Hospital, Xiamen University, Xiamen 361102, Fujian Province, China.
Institute of Stem Cell and Regenerative Medicine, School of Medicine, Xiamen University, Xiamen 361102, Fujian Province, China.
World J Clin Cases. 2021 Feb 6;9(4):935-942. doi: 10.12998/wjcc.v9.i4.935.
Primary retroperitoneal tumor is a rare type of tumor with insidious onset, large tumor size at the time of diagnosis, and often extensive involvement of surrounding tissues and blood vessels in the retroperitoneum. Surgery for primary retroperitoneal tumors is technically challenging. Preoperative imaging evaluation is critical for the selection of the optimal surgical approach and can influence complete resection and recurrence rates. Three-dimensional model reconstruction combined with virtual reality is useful for preoperative assessment.
A 17-year-old female patient was admitted for abdominal pain lasting for half a year that had been worsening for half a month. Abdominopelvic enhanced helical computed tomography revealed a retroperitoneal space-occupying lesion about 11.3 cm × 9.1 cm in size, with well-defined borders in the upper left quadrant of the abdomen. The lesion compressed the left renal artery and vein resulting in vascular displacement and deformation. A multidisciplinary team decided on the optimal treatment approach. Preoperative three-dimensional visualization and virtual reality technology were used to assess and simulate the surgical procedure. Then, retroperitoneal tumor resection along with renal artery reconstruction was decided as the treatment. Complete resection of the retroperitoneal tumor was performed. Stable blood flow was established after renal artery reconstruction. The tumor was diagnosed as mature cystic teratoma (retroperitoneal tumor) by postoperative pathologic analysis. The patient, who recovered well, was discharged after 2 wk and maintains regular follow-ups.
A combination of three-dimensional reconstruction and virtual reality technology before surgery improves the rate of complete resection of retroperitoneal teratoma.
原发性腹膜后肿瘤是一种罕见的肿瘤，起病隐匿，诊断时肿瘤体积较大，且常广泛累及腹膜后周围组织和血管。原发性腹膜后肿瘤的手术在技术上具有挑战性。术前影像学评估对于选择最佳手术方式至关重要，并且会影响完整切除率和复发率。三维模型重建结合虚拟现实技术有助于术前评估。
一名17岁女性患者因腹痛半年、加重半月入院。腹盆腔螺旋CT增强扫描显示腹膜后占位性病变，大小约11.3 cm×9.1 cm，位于左上腹，边界清晰。病变压迫左肾动静脉，导致血管移位和变形。多学科团队确定了最佳治疗方案。术前采用三维可视化和虚拟现实技术评估并模拟手术过程。随后，决定行腹膜后肿瘤切除术并重建肾动脉。腹膜后肿瘤被完整切除。肾动脉重建后血流稳定。术后病理分析诊断肿瘤为成熟囊性畸胎瘤（腹膜后肿瘤）。患者恢复良好，术后2周出院，定期随访。
术前三维重建与虚拟现实技术相结合可提高腹膜后畸胎瘤的完整切除率。
