经脐单孔腹腔镜巨大腹膜后囊腺瘤剥除术一例

A case report regarding a large postperitoneal cystic adenomas with transumbilical laparoendoscopic single site surgery

目的探讨经脐单孔腹腔镜下巨大腹膜后囊腺瘤剥除术的诊疗特点、手术决策及围手术期需关注的问题。方法选取柳州市柳铁中心医院妇科1例巨大腹膜后囊腺瘤的病例,复习文献并选择单孔腹腔镜手术的手术路径,进行多学科诊疗模式会诊就围手术期可能出现的并发症及处理对策进行探讨。结果手术于2021年8月顺利完成,术中出血量100 ml,术后恢复顺利,无并发症。术后随访至2021年10月患者恢复良好。结论对于腹膜后囊肿的手术方式,单孔腹腔镜手术是可行的,特别是对于巨大的单房囊肿,经单孔下减容、囊壁提出腹壁切口外剥离及缝合可大大提高手术效率,但腹膜后肿物由于位置深、毗邻大血管,单孔腹腔镜手术完成剥除难度较大,需要具备较为熟练的单孔腹腔镜手术基本功。同时仍需要更多数据来验证此术式的安全性和有效性。

Objective Through the transumbilical laparoendoscopic single site surgery to removal of a giant retroperitoneal cystic adenoma,the diagnosis and treatment characteristics,surgical decisions and the issues of perioperative disease were discussed.Methods A case of a giant retroperitoneal cystic adenoma of Liuzhou Municipal Liutie Central Hospital,reviewed the literature and selected the surgical path of a single-hole laparoscopy,and conducted a multidisciplinary consultation to discuss the possible complications of the perioperative period and the treatment countermeasures.Results The operation was successfully completed,bleeding for 100 ml,and a smooth postoperative recovery without complications.The patient has recovered well since the postoperative follow-up.Conclusions For the surgical mode of retroperitoneal cysts,single-hole laparoscopy is feasible,especially for large single-chamber cysts,the cyst effusion volume was reduced by transumbilical laparoendoscopic single site surgery,at the same time,the cyst wall and suture wound can be removed through the abdominal wall incision to increase the surgical efficiencythe cystic;its disadvantage is that due to the deep anatomical location of the retroperitoneal swelling and adjacent to the large blood vessels,it is more difficult to complete the single-hole laparoscopic removal,which requires the more skilled basic skills of single-hole laparoscopic surgery.More data are needed to confirm the safety and efficacy of the procedure.