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成功实施腹腔镜辅助切除一名17岁男孩因伯基特淋巴瘤导致的肠梗阻

Successful Laparoscopy-Assisted Extirpation of Burkitt's Lymphoma Causing Intestinal Obstruction in a 17-Year-Old Boy.

作者信息

Derzsi Zoltán, Bara Zsolt, Horváth Emőke, Serac Gabriel, Mărginean Răzvan, Sólyom Réka, Kovács Evelyn, Gozar Horea

机构信息

Department of Pediatric Surgery and Orthopedics, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Targu Mures, 540142 Târgu Mureș, Romania.

Clinic of Pediatric Surgery and Orthopedics, Targu Mures, County Emergency Clinical Hospital, 540136 Târgu Mureș, Romania.

出版信息

J Clin Med. 2024 Dec 22;13(24):7834. doi: 10.3390/jcm13247834.

Abstract

Childhood extranodal B-cell non-Hodgkin's lymphomas are often caused by Burkitt's lymphoma (BL). Treatment usually involves intensive polychemotherapy, and recent prospective trials show significantly improved outcomes. Surgery primarily involves conducting biopsies; ablative interventions are not recommended. However, in cases of severe presentation, such as an acute abdomen, emergency surgery may be necessary. We present the case of a 17-year-old boy who underwent emergency surgery due to intestinal obstruction caused by a tumor mass. An exploratory laparoscopy was performed due to abdominal wall infiltrates, and a large intraabdominal mass was discovered in the ileocaecal region. The tumor and tumor infiltrates were successfully removed en bloc in a minimally invasive laparoscopy-assisted fashion. The postoperative course was favorable, and chemotherapy was started. Histopathology confirmed the diagnosis of BL. Follow-up examinations, including a positron emission tomography (PET) scan, showed no tumor recurrence. More than two years later, the patient remains asymptomatic with negative PET scans. Laparoscopy-assisted removal can be useful for pediatric solid abdominal tumors with abdominal wall infiltrates that cause obstruction. Surgeons must assess indications and procedures based on imaging and findings during emergency interventions. The role of ablative MIS in pediatric BL is limited.

摘要

儿童结外B细胞非霍奇金淋巴瘤通常由伯基特淋巴瘤(BL)引起。治疗通常包括强化多药化疗,最近的前瞻性试验显示预后有显著改善。手术主要是进行活检;不建议进行根治性干预。然而,在出现严重症状的情况下,如急腹症,可能需要进行急诊手术。我们报告一例17岁男孩因肿瘤肿块导致肠梗阻而接受急诊手术的病例。由于腹壁浸润进行了探查性腹腔镜检查,在回盲部发现一个巨大的腹腔内肿块。以微创腹腔镜辅助方式成功整块切除肿瘤及肿瘤浸润组织。术后病程顺利,并开始化疗。组织病理学确诊为BL。包括正电子发射断层扫描(PET)在内的随访检查显示无肿瘤复发。两年多后,患者无症状,PET扫描结果为阴性。腹腔镜辅助切除对于伴有腹壁浸润并导致梗阻的小儿腹部实体肿瘤可能有用。外科医生必须根据急诊干预期间的影像学检查和发现来评估适应症和手术方法。根治性微创外科手术在小儿BL中的作用有限。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9627/11676663/9a0521dd5176/jcm-13-07834-g001.jpg

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