腹腔镜下骶前囊肿切除术33例临床分析

Clinical analysis of 33 cases on laparoscopic resection of presacral cysts

目的总结采用腹腔镜技术切除骶前囊肿的经验和教训,推广微创外科技术在该疾病治疗中的应用.方法回顾分析2012年11月至2017年6月33例中国医学科学院北京协和医院收治的骶前囊肿患者采用腹腔镜技术治疗的临床资料.统计其手术时间,术中和术后并发症的发生率以及术后住院时间.结果全组按计划完成肿物切除,无中转开腹手术.手术时间(124.4±62.0)min.术中发生直肠损伤1例,骶前静脉丛出血1例,术中并发症6%.术后并发直肠漏2例,占6%.术后住院时间为(6.7±4.3)d. 33例中2例失访. 1例于术后1 年出现骶前囊肿复发.结论采用腹腔镜技术切除骶前囊肿在技术上是可行的,并有助于改善术中显露,增加操作空间,提高对肿瘤的切除率.

Objective To summarize and analyze our experiences uponperforming laparoscopic resection ofpresacral cysts, at the aim of generalizing the minimally invasive surgery in the treatment of this disease. Methods The clinical data of 33 patients with presacral cysts treated by laparoscopy in Peking Union Medical College Hospital of Chinese Academy of Medical Sciences from November 2012 to June 2017 were retrospectively analyzed.The operation time, the incidence of intraoperative and postoperative complications and the length of hospital stay were counted. Results Tumor excision was completed according to the plan without conversion to open surgery.The average operation time was (124.4±63.0)minutes.There were 1 case of rectal injury and 1 case of presacral venous plexus hemorrhage.The complications were 6%.Postoperative rectal leakage occurred in 2 cases (6%). The average hospitalization time after operation was (6.7±4.3)days.Of 33 cases, 2 cases were lost.One case had recurrence of presacral cyst one year after operation. Conclusion Laparoscopic resection of presacral cysts is technically feasible, and helps to improve intraoperative exposure, increase operating space and improve the resection rate of tumors.