Abstract: Objective:To investigate the clinical efficacy of laparoscopic resection for retroperitoneal tumor via transabdominal approach.
Methods:The retrospective cross-sectional study was conducted. The clinicopathological data of 37 patients with retroperitoneal tumor who underwent laparoscopic resection via transabdominal approach at Fujian Medical University Union Hospital between January 2011 and August 2017 were collected. The surgical approach of resection for retroperitoneal tumor at the left hypochondriac region, left iliac region, right hypochondriac region and right iliac region referred to laparoscopic distal pancreatectomy, laparoscopic left hemicolectomy, laparoscopic pancreatoduodenectomy and laparoscopic right hemicolectomy respectively. Observation indicators: (1) intra and post-operative recovery situations; (2) followup and survival situations. Followup using outpatient examination and telephone interview was performed to detect post-operative tumor recurrence, metastasis and survival of patients up to November 2017. Measurement data with normal distribution were represented as ±s. Measurement data with skewed distribution were described as M (range).
Results:(1) Intra and post-operative recovery situations: 37 patients underwent successfully laparoscopic resection for retroperitoneal tumor via transabdominal approach. Among 37 patients, 4 were converted to open surgery, 4 were completed surgery with assisted small incision, 4 were combined with adjacent organ resection and other 25 underwent totally laparoscopic resection for retroperitoneal tumor. The operation time, volume of intraoperative blood loss, post-operative gastrointestinal recovery time, post-operative drainagetube removal time and duration of post-operative hospital stay were respectively (181±73)minutes, (160±87)mL, (3.0±1.0)days, (3.0±2.0)days and (7± 4)days. Of 37 patients, 3 with post-operative complications including 2 of chylous fistula and 1 of delayed gastric emptying were improved by symptomatic treatment. There was no perioperative death. (2) Followup and survival situations: 37 patients were followed up for 3-82 months, with a median time of 30 months. During the followup, 1 patient with inflammatory myofibroblastic tumor had recurrence at 15 months post-operatively and underwent surgical resection, however, the patient had liver metastasis at 9 months after the second operation and underwent interventional therapy repeatly. One patient with Castleman and 5 with lymphoma underwent regular chemotherapy and achieved disease-free survival. The other patients had disease-free survival.
Conclusion:Laparoscopic resection for retroperitoneal tumor via transabdominal approach is safe and feasible.