論文

査読有り
2016年10月

Laparoscopic resection of paraaortic/paracaval neurogenic tumors: surgical outcomes and technical tips

SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES
  • Takashige Abe
  • ,
  • Ataru Sazawa
  • ,
  • Toru Harabayashi
  • ,
  • Yuichiro Oishi
  • ,
  • Naoto Miyajima
  • ,
  • Kunihiko Tsuchiya
  • ,
  • Satoru Maruyama
  • ,
  • Hiromi Okada
  • ,
  • Nobuo Shinohara

30
10
開始ページ
4640
終了ページ
4645
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1007/s00464-015-4740-6
出版者・発行元
SPRINGER

Due to variations in location and size, laparoscopic surgery for paraaortic or paracaval neurogenic tumors is challenging. We evaluated the surgical outcomes, as well as surgical tips and tricks.
Between 2000 and 2015, 25 procedures were performed in 24 patients. One patient underwent second surgery due to the recurrence of paraganglioma. Data were collected on the tumor diameter, tumor location, perioperative outcomes, pathology, and last-known disease status. Regarding the operative procedures, we reviewed the operative charts or videos to identify surgical tips and tricks.
The median tumor diameter was 5.0 cm (range 1.5-10). The tumor location was suprahilar in 10, hilar in 6, and infrahilar in 9 cases. Regarding the approach, a transperitoneal approach was selected in 24 cases and retroperitoneal approach in 1. The median operative time and blood loss were 208 min (range 73-513) and 10 mL (range 0-1020), respectively. No patient required blood transfusion or conversion to open surgery. Pathological examination revealed paraganglioma in 12, ganglioneuroma in 7, and schwannoma in 6 cases. At the last follow-up, 23 patients were free of disease, while one patient developed metastatic multiple recurrence of paraganglioma 54 months after the second laparoscopic surgery. A review of the surgical records revealed several tips and tricks, including taping the vena cava/renal vein (n = 2) being helpful for detaching a retrocaval tumor from these great vessels, or rotating the kidney to provide a favorable operative view of tumors behind the renal hilum (n = 2). In recent cases, 3D-CT was helpful for preoperative planning.
Laparoscopic resection of paraaortic or paracaval neurogenic tumors is feasible in experienced hands. Surgeons should be familiar with detaching maneuvers around great vessels and the mobilization of adjacent organs. Careful preoperative planning is mandatory.

Web of Science ® 被引用回数 : 7

リンク情報
DOI
https://doi.org/10.1007/s00464-015-4740-6
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/26715023
Web of Science
https://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcAuth=JSTA_CEL&SrcApp=J_Gate_JST&DestLinkType=FullRecord&KeyUT=WOS:000382756400063&DestApp=WOS_CPL

エクスポート
BibTeX RIS