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腹腔镜两步法腹骶部巨大盆腔脂肪瘤切除术：病例报告

Laparoscopic two-step abdomino-parasacral resection of a giant pelvic lipoma: a case report.

作者信息

Jiao Yurong, Mongardini Federico Maria, Liu Hui, Cricrì Michele, Xie Haiting, Docimo Ludovico, Li Jun

机构信息

Department of Colorectal Surgery and Oncology (Key Laboratory of Cancer Prevention and Intervention, China National Ministry of Education, Key Laboratory of Molecular Biology in Medical Sciences), The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.

Division of General, Oncological, Mini-Invasive and Obesity Surgery, University of Study of Campania "Luigi Vanvitelli", Naples, Italy.

出版信息

J Gastrointest Oncol. 2024 Aug 31;15(4):1926-1932. doi: 10.21037/jgo-24-29. Epub 2024 Aug 7.

DOI:10.21037/jgo-24-29
PMID:39279948
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11399849/
Abstract

BACKGROUND

Pelvic lipomas, particularly when massive in size, present unique surgical challenges due to their intricate anatomical location and proximity to vital structures. Complete resection of tumor is the basic principle. In this case, we demonstrated the complete resection of a huge pelvic lipoma by laparoscopy combined with a transsacral approach, which was rarely reported in the relevant literature. According to our case, a two-step abdomino-parasacral approach provides more flexibility, but also a safe and easier dissection in deep pelvic.

CASE DESCRIPTION

A 74-year-old female presented to the outpatient clinic, complaining of abdominal distension and difficulty in defecation for over 6 months. The patient had no obvious concomitant symptoms and she had a history of hypertension. After completing the relevant tests, the patient was diagnosed with a pelvic tumor, possibly a lipoma. We performed a two-step abdomino-parasacral approach to remove the tumor and the tumor was confirmed as lipoma. There was no tumor recurrence sign after 7 months follow-up for the patient.

CONCLUSIONS

A two-step abdomino-parasacral resection of the lipomatous tumor were advantageous to manage resection of a giant pelvic lipoma in our case report. This case report can provide some reference for the treatment of pelvic giant lipoma in the future.

摘要

背景

盆腔脂肪瘤，尤其是体积巨大时，因其复杂的解剖位置及与重要结构的毗邻关系，给手术带来独特挑战。完整切除肿瘤是基本原则。在此病例中，我们展示了通过腹腔镜联合经骶骨入路完整切除巨大盆腔脂肪瘤的方法，这在相关文献中鲜有报道。根据我们的病例，经腹 - 骶骨两步入路提供了更大的灵活性，且在盆腔深部的解剖操作更安全、简便。

病例描述

一名74岁女性到门诊就诊，主诉腹胀及排便困难6个月余。患者无明显伴随症状，有高血压病史。完成相关检查后，患者被诊断为盆腔肿瘤，可能为脂肪瘤。我们采用经腹 - 骶骨两步入路切除肿瘤，术后病理证实为脂肪瘤。患者随访7个月无肿瘤复发迹象。

结论

在我们的病例报告中，经腹 - 骶骨两步切除脂肪瘤性肿瘤有利于处理巨大盆腔脂肪瘤的切除。本病例报告可为未来盆腔巨大脂肪瘤的治疗提供一些参考。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cb0e/11399849/b0695f180260/jgo-15-04-1926-f7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cb0e/11399849/6c7f4afb5f85/jgo-15-04-1926-f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cb0e/11399849/2bc8c9f80015/jgo-15-04-1926-f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cb0e/11399849/014fc10bbe3f/jgo-15-04-1926-f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cb0e/11399849/83551ac3dfaf/jgo-15-04-1926-f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cb0e/11399849/458e0a693a34/jgo-15-04-1926-f5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cb0e/11399849/09ed0f30c563/jgo-15-04-1926-f6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cb0e/11399849/b0695f180260/jgo-15-04-1926-f7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cb0e/11399849/6c7f4afb5f85/jgo-15-04-1926-f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cb0e/11399849/2bc8c9f80015/jgo-15-04-1926-f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cb0e/11399849/014fc10bbe3f/jgo-15-04-1926-f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cb0e/11399849/83551ac3dfaf/jgo-15-04-1926-f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cb0e/11399849/458e0a693a34/jgo-15-04-1926-f5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cb0e/11399849/09ed0f30c563/jgo-15-04-1926-f6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cb0e/11399849/b0695f180260/jgo-15-04-1926-f7.jpg

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本文引用的文献

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Robotic resection of a lipoma in the deep lesser pelvis - a video vignette.低位盆腔深部脂肪瘤的机器人切除术——视频病例
Colorectal Dis. 2023 Jun;25(6):1318. doi: 10.1111/codi.16542. Epub 2023 Mar 27.
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Int J Surg Case Rep. 2014;5(12):975-8. doi: 10.1016/j.ijscr.2014.10.030. Epub 2014 Oct 17.
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