腹腔镜手术治疗原发性腹膜后副神经节瘤的疗效分析

Clinical effectiveness of laparoscopic surgery for treatment of retroperitoneal paragangliomas

目的:探讨腹腔镜手术治疗原发性腹膜后副神经节瘤(PGL)的安全性和疗效。方法:回顾性分析2008年7月～2017年7月我院收治住院且经病理确诊为原发性腹膜后PGL的43例患者的临床资料。按手术方式分为腹腔镜组(28例)和开放手术组(15例),比较两组术中、术后及预后相关指标。结果:手术全部成功切除肿瘤,两组肿瘤大小、手术时间和术中血压波动差异无统计学意义(P>0.05);腹腔镜组术中出血量显著低于开放手术组,差异有统计学意义[(185.2±88.4)ml vs.(286.4±179.8)ml,P<0.05];腹腔镜组术中输血4例,术后发生并发症2例;开放组术中输血8例,术后发生并发症6例。术后随访6个月～8年,肿瘤复发与转移5例,其中2例患者局部复发,再次行开放肿瘤切除术。结论:腹腔镜下治疗腹膜后PGL与开放手术相比,不会增加术中血流动力学风险和手术时间,在减少术中出血、降低手术并发症和加快术后恢复方面优势明显,是一种相对安全有效的治疗方式。

Objective：To explore the safety and efficacy of laparoscopic surgery on the treatment of retroperitoneal paragangliomas（PGL）.Method：Forty-three patients of retroperitoneal PGL treated with laparoscopic or open resection in our hospital between July 2008 and July 2017 were reviewed.Perioperative outcomes of 28 laparoscopic resections were compared with 15 open resections.Result：All operations were successfully completed.There was no statistically significant difference in tumour size or average operating time（P〉0.05）.The blood loss was less in laparoscopic group[（185.2±88.4）ml vs.（286.4±179.8）ml,P〈0.05）].The number of blood transfusion and postoperative complications in laparoscopic group were 4 cases and 2 cases while 8 cases and 6 cases in open group respectively.Time of postoperative stay was shorter in the laparoscopic group[（9.6±1.6）d vs.（11.9±1.5）d,P〈0.05）].After a follow-up period of 6-96 months,5 patients recurred.Two of them underwent secondary open resection because of local recurrence.Conclusion：Our application of laparoscopic resections in retroperitoneal PGL shows it is a safe and effective operation method.