3D腹腔镜切除复杂盆腔巨大原发肿瘤3例临床分析

Clinical analysis of 3Dlaparoscopy for excision of three cases of complex and giant extra-organic primary pelvic tumor

目的:报告3例复杂性盆腔巨大原发非脏器来源肿瘤盆腔原发肿瘤的临床特点以及3D腹腔镜切除手术的方法,分析手术的可行性、安全性及3D腹腔镜的优势。方法:手术均采用3D腹腔镜技术经腹腔入路进行肿瘤切除。进入腹腔后明确肿瘤与邻近周围器官关系及界限,用ligasure和超声刀充分游离肿物,肿瘤较大而盆腔操作空间有限,游离肿瘤期间注意保护乙状结结肠、直肠和膀胱等周围邻近器官。结果:3例手术均获得成功,手术时间分别为225min、58min、50min,术中出血量分别为300ml、200ml、50ml,术后住院时间分别为7、7、8d,3例均无围手术期并发症。术后随访,2例良性肿瘤均无复发;1例恶性间皮瘤术后维持化疗,无复发。结论:3D腹腔镜下切除盆腔巨大原发肿瘤是安全可行的,具有创伤小、出血少、术后恢复较快等优点。

Objective：To describe the clinical features and surgical procedure of 3D laparoscopic instruments for three cases of complex giant extra-organic primary pelvic tumor, and analyze the feasibility, safety and advantages of this surgical procedure. Method：The tumors were resected by 3D laparoscopic techniques through intraperitoneal approach. After entering the abdominal cavity, the mass was fully dissected along the boundaries between the tumor and surrounding organs with Ligasure and ultrasonic scalpel. The sigmoid colon, rectum, bladder and semi- nal vesicles should be carefully protected during the procedure because of the large size tumor and limited operating space. Result：All three cases were performed successfully. Operative time was 225, 58, 50 min and blood loss was 300, 200, 50 ml respectively. Postoperative hospital stay was 7, 7, 8 days respectively and no perioperative com- plications were observed. Two cases of benign spindle cell tumors and one case of malignant mesothelioma after postoperative chemotherapy were followed up without recurrence. Conclusion： It is feasible and safe to remove com- plex giant extra-organic primary pelvic tumor using 3D laparoscopy because of its advantages of little trauma, little blood loss and quick recovery.