Wu Guo-Zhen, Fang Shen-Zhe, Yu Shi-An, Yu Min
Department of Hepatobiliary and Pancreatic Surgery, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua 321000, Zhejiang Province, China.
World J Gastrointest Surg. 2025 Aug 27;17(8):109213. doi: 10.4240/wjgs.v17.i8.109213.
Ganglioneuroma is a rare, well-differentiated, slow-growing benign tumor of the peripheral nerves, with surgical resection being the only curative treatment. Surgical resection of ganglioneuromas encasing major blood vessels remains a substantial clinical challenge. Traditionally, these cases often require open abdominal surgery or combined organ resections, and in some instances, the tumors are considered unresectable. Currently, no reports have described the resection of such tumors laparoscopy.
A 35-year-old woman was admitted to our hospital after the incidental discovery of a retroperitoneal space-occupying lesion. Imaging revealed a mass with the celiac axis and superior mesenteric artery passing through it. A neurogenic tumor was suspected, with ganglioneuroma being the most likely diagnosis. Following comprehensive preoperative preparation, the retroperitoneal tumor was resected using a three-dimensional laparoscopy combined with an organ suspension technique. The surgical approach involved incising the tumor along the vascular axis and conducting meticulous, vascular-preserving tumor excision. The operation lasted approximately 458 minutes, with an estimated blood loss of 50 mL. The patient was discharged on the 8th postoperative day. A transient liver injury occurred after surgery but improved rapidly. After 11 months of postoperative follow-up, no complications or tumor recurrence were observed.
This case illustrates the feasibility of minimally invasive laparoscopic resection for retroperitoneal ganglioneuromas encasing major blood vessels.
神经节细胞瘤是一种罕见的、分化良好、生长缓慢的周围神经良性肿瘤,手术切除是唯一的治愈性治疗方法。切除包裹主要血管的神经节细胞瘤仍然是一项重大的临床挑战。传统上,这些病例通常需要开腹手术或联合器官切除,在某些情况下,肿瘤被认为无法切除。目前,尚无关于此类肿瘤腹腔镜切除的报道。
一名35岁女性在偶然发现腹膜后占位性病变后入院。影像学检查显示一个肿块,腹腔干和肠系膜上动脉从中穿过。怀疑是神经源性肿瘤,最可能的诊断是神经节细胞瘤。经过全面的术前准备,采用三维腹腔镜联合器官悬吊技术切除腹膜后肿瘤。手术方法包括沿血管轴切开肿瘤,并进行细致的、保留血管的肿瘤切除。手术持续约458分钟,估计失血量50毫升。患者术后第8天出院。术后发生短暂性肝损伤,但恢复迅速。术后随访11个月,未观察到并发症或肿瘤复发。
该病例说明了微创腹腔镜切除包裹主要血管的腹膜后神经节细胞瘤的可行性。