机器人辅助腹腔镜治疗儿童腹膜后神经鞘瘤1例并文献复习

Robot-assisted laparoscopy for retroperitoneal schwannoma in children:one case report with a literature review

目的探讨机器人辅助腹腔镜手术治疗儿童腹膜后神经鞘瘤的疗效及安全性。方法以上海市儿童医院2020年10月收治的1例腹膜后神经鞘瘤患儿为研究对象,回顾分析其临床资料。结合文献复习对机器人辅助腹腔镜手术治疗儿童腹膜后神经鞘瘤的疗效及安全进行讨论分析。结果该患儿为15岁女童,以间歇性腰背部疼痛为主要症状,影像学检查提示右侧腹膜后肿物,边界尚清,周围脏器未见明显肿瘤浸润。血液学检查未见异常。完善术前准备后行机器人辅助腹腔镜下右侧腹膜后肿瘤切除术。术中见肿瘤大小约10 cm×6 cm×5 cm,包膜完整,予完整切除肿瘤。手术时长5 h,术中出血约450 mL,未输血。术后病理检查诊断为经典型神经鞘瘤。术后3 d出院。随访17个月,无腰背部疼痛等不适,肿瘤无复发。结论儿童腹膜后神经鞘瘤临床罕见,机器人辅助腹腔镜技术可安全有效地根治儿童巨大腹膜后肿瘤。

Objective To explore the efficacy and safety of robotic-assisted laparoscopy for children with retroperitoneal schwannoma.Methods A hospitalized 15-year-old girl with retroperitoneal schwannoma in October 2020 was selected and the relevant clinical data were retrospectively reviewed.Results Intermittent low back pain was a major symptom.Imaging examination revealed a right retroperitoneal mass with a distinct boundary and no obvious tumor infiltration in adjacent organs.Hematological tests showed no abnormalities.After complete preoperative preparation,robot-assisted laparoscopic complete resection of right retroperitoneal tumor was performed.Tumor size was around 10 cm×6 cm×5 cm and capsule remained intact.During 5h operation,intraoperative blood loss was around 450 ml without blood transfusion.Postoperative pathological examination confirmed the diagnosis of classical schwannoma.Discharge occurred at Day 3 post-operation.During a follow-up period of 17 months,there was no back pain,other discomforts or tumor recurrence.Conclusion Retroperitoneal schwannoma is rare in children.Robot-assisted laparoscopy can be safely and effectively applied to Children's large retroperitoneal tumors.