腹腔镜腹膜后淋巴结活检在疾病诊断中的作用

Laparoscopic biopsy of retroperitoneal lymph nodes in the diagnosis of diseases

目的探讨腹腔镜腹膜后淋巴结活检在疾病诊断中的价值。方法2000年6月～2002年12月,对6例腹膜后淋巴结肿大行腹腔镜探查和腹膜后淋巴结活检,其中1例同时行肠粘连松解术。结果6例分别取出1～3枚05～12cm大小的淋巴结,病理诊断分别是原发性腹膜炎1例,结核性腹膜炎伴淋巴结核1例,淋巴瘤3例,慢性淋巴细胞白血病1例。术后无并发症,1例术后13d死于原发病引起的多脏器功能衰竭。结论腹腔镜后腹膜淋巴结活检为后腹膜淋巴结肿大提供安全有效的诊断手段。

Objective To discuss the value of laparoscopic biopsy of retroperitoneal lymph nodes in the diagnosis of diseases.Methods Six consecutive patients with enlargement of retroperitoneal lymph nodes underwent laparoscopic exploration and retroperitoneal lymph node biopsy between June 2000 and December 2002. One of the patients also underwent enterolysis. Results A total of 1～3 lymph nodes were removed respectively in the 6 patients, with a diameter of 0 5～1 2 cm. Pathological diagnosis included 1 case of primary peritonitis, 1 case of tuberculous peritonitis accompanying lymphoid tuberculosis, 3 cases of lymphoma, and 1 case of chronic lymphocytic leukemia. There were no postoperative complications, but 1 case died of MSOF originated from primary disease on the 13th postoperative day. Conclusions Laparoscopic biopsy of retroperitoneal lymph nodes offers a safe and effective alternative in the diagnosis of enlargement of retroperitoneal lymph nodes.