腹腔镜与开腹骶前肿瘤切除术的临床疗效比较_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

王攀 ^1,2 , 周程继 ^1,2 , 喻晶 ^1,2 , 魏寿江 ¹ ,  王崇树 ¹

1. ;
2. ;

Corresponding author：

王崇树, Email: chongs-wang@163.com

Keywords：

骶前肿瘤; 腹腔镜; 开腹手术; 疗效

DOI：

10.7507/1007-9424.201611061

Video：

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目的探讨腹腔镜下骶前肿瘤切除术的可行性和安全性。方法回顾性分析 2006 年 3 月至 2015 年 12 月期间于川北医学院附属医院行腹腔镜骶前肿瘤切除术（n=6）或传统开腹骶前肿瘤切除术（n=43）的 49 例原发性骶前肿瘤患者的临床资料，比较腹腔镜组和开腹组患者的术中出血量、手术时间、术后肛门排气时间、住院时间、卧床时间、并发症等临床指标。结果所有患者的肿瘤均被完整切除，无一例围手术期死亡。2 组患者的术中出血量、术后肛门排气时间、住院时间及卧床时间比较差异均有统计学意义（P<0.05），与开腹组比较，腹腔镜组的术中出血量少，术后肛门排气早，住院时间和卧床时间均较短；但 2 组患者的手术时间、总并发症发生率、切口并发症发生率、粘连性肠梗阻发生率及肿瘤复发率比较差异均无统计学意义（P>0.05）。出院后所有患者获随访，随访时间 6～24 个月，中位数为 16 个月。随访期间开腹组有 3 例发生肿瘤复发（2 例为恶性畸胎瘤，1 例为脂肪肉瘤），腹腔镜组患者无一例肿瘤复发。结论与开腹手术相比，腹腔镜下骶前肿瘤切除术具有术中出血少、术后恢复快、住院时间及卧床时间短的优点，腹腔镜下行原发性骶前肿瘤切除术是安全和可行的。

Citation： 王攀, 周程继, 喻晶, 魏寿江, 王崇树. 腹腔镜与开腹骶前肿瘤切除术的临床疗效比较. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2017, 24(9): 1130-1133. doi: 10.7507/1007-9424.201611061 Copy

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14.	Akiyoshi T, Kuroyanagi H, Oya M, et al. Short-term outcomes of laparoscopic rectal surgery for primary rectal cancer in elderly patients: is it safe and beneficial? J Gastrointest Surg, 2009, 13(9): 1614-1618.
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1. Mazreku A, Karaj A, Avdia I, et al. The presentation and management of presacral tumors. Acta Chir Iugosl, 2010, 57(2): 55-59.
2. Dubory A, Missenard G, Lambert B, et al. Interest of laparoscopy for " En Bloc” resection of primary malignant sacral tumors by combined approach: comparative study with open median laparotomy, Spine (Phila Pa 1976), 2015, 40(19): 1542-1552.
3. Drazin D, Bhamb N, Al-Khouja LT, et al. Image-guided resection of aggressive sacral tumors. Neurosurg Focus, 2017, 42(1): E15.
4. Uçar AD, Yoldaş T, Oymaci E, et al. Totally curative surgical resection of retrorectal tumors. Hepatogastroenterology, 2015, 62(139): 606-611.
5. Kim K, Chun SW, Chung SG. A case of symptomatic cervical perineural (Tarlov) cyst: clinical manifestation and management. Skeletal Radiol, 2012, 41(1): 97-101.
6. Thornton E, Krajewski KM, O’Regan KN, et al. Imaging features of primary and secondary malignant tumours of the sacrum. Br J Radiol, 2012, 85(1011): 279-284.
7. Akiyama T, Kanda S, Maeda A, et al. Inferior gluteal artery detection at the greater sciatic notch with a computer-assisted navigation system during pelvic and sacral tumor resection. Comput Assist Surg (Abingdon), 2016, 21(1): 18-24.
8. Pennicooke B, Laufer I, Sahgal A, et al. Safety and local control of radiation therapy for chordoma of the spine and sacrum: a systematic review. Spine (Phila Pa 1976), 2016, 41 Suppl 20: S186-S192.
9. Possover M, Uehlinger K, Ulrich Exner G. Laparoscopic assisted resection of a ilio-sacral chondrosarcoma: a single case report. Int J Surg Case Rep, 2014, 5(7): 381-384.
10. Lou Z, Zhang W, Meng RG, et al. Massive presacral bleeding during rectal surgery: from anatomy to clinical practice. World J Gastroenterol, 2013, 19(25): 4039-4044.
11. Enomoto T, Saida Y, Takabayashi K, et al. Open surgery versus laparoscopic surgery after stent insertion for obstructive colorectal cancer. Surg Today, 2016, 46(12): 1383-1386.
12. Yu LP, Dai GF, Duan JC, et al. Thin steel plate with thumbtack fixation in the treatment of massive presacral venous plexus hemorrhage. Chin Med J (Engl), 2011, 124(19): 3180-3181.
13. Kuroda S, Kikuchi S, Hori N, et al. Training system for laparoscopy-assisted distal gastrectomy. Surg Today, 2017, 47(7): 802-809.
14. Akiyoshi T, Kuroyanagi H, Oya M, et al. Short-term outcomes of laparoscopic rectal surgery for primary rectal cancer in elderly patients: is it safe and beneficial? J Gastrointest Surg, 2009, 13(9): 1614-1618.
15. Xie D, Yu C, Liu L, et al. Short-term outcomes of laparoscopic D2 lymphadenectomy with complete mesogastrium excision for advanced gastric cancer. Surg Endosc, 2016, 30(11): 5138-5139.
16. Yang Y, Niu X, Li Y, et al. Recurrence and survival factors analysis of 171 cases of sacral chordoma in a single institute. Eur Spine J, 2016, [Epub ahead of print].

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腹腔镜与开腹骶前肿瘤切除术的临床疗效比较

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