[1]丁宁,饶品德,吴文波,等.两种腹腔镜手术路径治疗儿童肾上腺区神经母细胞瘤的经验总结[J].临床小儿外科杂志,2022,21(02):136-140.[doi:10.3760/cma.j.cn.101785-202012030-007]
　Ding Ning,Rao Pinde,Wu Wenbo,et al.Two different surgical approaches of laparoscopic adrenalectomy for children with adrenal neuroblastoma[J].Journal of Clinical Pediatric Surgery,2022,21(02):136-140.[doi:10.3760/cma.j.cn.101785-202012030-007]
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两种腹腔镜手术路径治疗儿童肾上腺区神经母细胞瘤的经验总结

《临床小儿外科杂志》[ISSN:1671-6353/CN:43-1380/R] 卷: 第21卷 期数: 2022年02期 页码: 136-140 栏目: 专题·儿童神经母细胞瘤 出版日期: 2022-02-28
Title:
Two different surgical approaches of laparoscopic adrenalectomy for children with adrenal neuroblastoma
作者:
丁宁1;  饶品德1;  吴文波1;  黄金狮2;  张守华3;  唐静1;  熊春凤1;  王江华1
1 江西省儿童医院, 南昌大学附属儿童医院泌尿外科, 南昌 330006;
2 江西省儿童医院, 南昌大学附属儿童医院新生儿外科, 南昌 330006;
3 江西省儿童医院, 南昌大学附属儿童医院普外科, 南昌 330006
Author(s):
Ding Ning1;  Rao Pinde1;  Wu Wenbo1;  Huang Jinshi2;  Zhang Shouhua3;  Tang Jing1;  Xiong Chunfeng1;  Wang Jianghua1
1 Jiangxi Provincial Children’s Hospital, The Affiliated Children’s Hospital of Nanchang University Urology Surgery, Nanchang Jiangxi, 330006 China;
2 Jiangxi Provincial Children’s Hospital, The Affiliated Children’s Hospital of Nanchang University Neonatal Surgery, Nanchang Jiangxi, 330006 China;
3 Jiangxi Provincial Children’s Hospital, The Affiliated Children’s Hospital of Nanchang University General Surgery, Nanchang Jiangxi, 330006 China
关键词:
肾上腺区神经母细胞瘤; 外科手术; 腹腔镜检查; 手术路径; 儿童
Keywords:
Adrenal Neuroblastoma; Surgical Procedures;  Operative; Laparoscopy; Surgical Approach; Child
DOI:
10.3760/cma.j.cn.101785-202012030-007
摘要:
目的 评估两种腹腔镜手术路径治疗儿童肾上腺区神经母细胞瘤的可靠性及安全性。方法 回顾性分析2018年2月至2020年8月江西省儿童医院9例腹腔镜下行手术治疗的肾上腺区神经母细胞瘤患儿临床资料，其中男6例，女3例；年龄1个月至5岁5个月，平均年龄22个月。6例为右侧肾上腺区神经母细胞瘤，3例为左侧肾上腺区神经母细胞瘤。临床表现：2例为腹痛，1例为血尿，1例为腹泻，1例为腹胀，4例为体检发现。结果 9例术前经增强CT及彩超检查诊断为肾上腺区肿瘤，与周围脏器无浸润，下腔静脉无瘤栓；8例无淋巴结及远处转移，1例肝脏转移；内分泌检查均为无功能性肿瘤。9例中7例经腹腔途径手术，2例经腹膜后途径手术；9例均顺利、完整切除肿瘤，无一例中转开放手术，平均手术（腹腔镜操作）时间137 min，平均出血16.3 mL（5~40 mL），1例输血100 mL，肿瘤平均直径4.3 cm（2.5~5.4 cm）。术后病理检查结果：5例神经母细胞瘤，3例节细胞神经母细胞瘤，1例节细胞神经瘤。术后均恢复良好，Ⅰ期病例未行化疗，Ⅳ期肝脏转移病例术后予化疗，平均随访时间8.6个月（2~35个月），无一例复发。结论 两种腹腔镜手术路径切除儿童肾上腺区神经母细胞瘤均安全、有效，腹膜后途径在显露及血管处理上更具优势，腹腔途径在操作空间上更具优势。
Abstract:
Objective To evaluate the reliability and safety of two different surgical approaches of laparoscopic adrenalectomy for children with adrenal neuroblastoma.Methods A retrospective study was performed for five children undergoing laparoscopic adrenalectomy from February 2018 to August 2020.There were 6 boys and 3 girls with an average age of 22(1-65) months.The involved side was left (n=3) and right (n=6).There were abdominal pain (n=2), hematuria (n=1), diarrhea (n=1), abdominal distension (n=1) and non-discomfort (n=4).Retroperitoneal (n=2) and transperitoneal (n=3) laparoscopies were performed.All procedures were successfully performed without any conversion into open surgery.The average operative duration was 137 min, the mean estimated volume of blood loss 16.3(5-40) ml and the mean tumor diameter 4.3(2.5-5.4) cm.Histopathological examination hinted at neuroblastoma (n=5), ganglioneuroblastoma (n=3) and ganglioneuroma (n=1).Results All of them recovered well postoperatively during a mean follow-up period of 8.6(2-35) months.There was no onset of recurrence or metastasis.Conclusion Two different approaches of laparoscopic adrenalectomy may be safely and effectively performed for neuroblastoma.Retroperitoneal laparoscopy offers an advantage over exposing and handling blood vessels while transperitoneal laparoscopy is superior for operating space.

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备注/Memo

收稿日期:2020-03-08。
基金项目:江西省卫健委科研计划项目（202110098）
通讯作者:饶品德,Email:65991994@qq.com

更新日期/Last Update: 1900-01-01