目的探讨原发性腹膜后肿瘤行腹腔镜手术的安全性和疗效。 方法回顾性分析新疆医科大学第二附属医院普外科2008年4月至2013年4月期间行腹腔镜手术治疗的12例原发性腹膜后肿瘤患者的临床资料。 结果12例患者均行腹腔镜手术，其中1例中转开腹手术，其余行腹腔镜手术成功。平均手术时间190 min，术中平均出血300 mL，术后平均8.5 d出院。术后左下肢深静脉血栓形成1例，经保守治疗好转。围手术期无死亡患者。术后病理类型：良性肿瘤5例，其中神经鞘瘤1例，脂肪瘤1例，腹膜后囊肿2例，畸胎瘤1例；恶性肿瘤7例，其中纤维肉瘤2例，平滑肌肉瘤1例，恶性淋巴瘤2例，脂肪肉瘤2例。良性肿瘤平均直径8.1 cm，恶性肿瘤平均直径5.6 cm。随访7例恶性肿瘤患者，平均随访时间13个月，无复发及转移。 结论通过本组有限的病例资料初步得出，原发性腹膜后肿瘤的诊断主要依靠影像学检查。对于肿瘤直径≤10 cm的良性肿瘤或直径≤6 cm的恶性肿瘤且未侵犯主要血管者行腹腔镜手术治疗安全、可行。
ObjectiveTo explore the effects of CO2 pneumoperitoneum and posture on circulation function for elderly patients with rectal cancer during laparoscopic operation. MethodsRetrospective analysis of clinical data of 48 elderly patients with rectal cancer was performed, and the data included the heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), cardiac output (CO), cardiac index (CI), central venous pressure (CVP), pH, partial pressure of oxygen (PaO2), and partial pressure of carbon dioxide (PaCO2) at before anesthesia (T1), after anesthesia (T2), after the establishment of CO2 pneumoperitoneum (T3), placement in trendelenburg position after operation (T4), 30 minutes after operation (T5), 60 minutes after operation (T6), 90 minutes after operation (T7), and 120 minutes after operation (T8). ResultsThe levels of HR, SBP, DBP, MAP, CO, CI, pH, PaO2, and PaCO2 at 8 time points didn't statistically differed with each other (P>0.05), but the levels of CVP at T7 and T8 time point were significantly higher than those of T1 and T2 time point (P<0.05). ConclusionsDuring laparoscopic operation period for the elderly patients with rectal cancer, the CVP will gradually increase. If the preoperative assessment and administration are done well during peri-operation period, laparoscopic operation is safe for the elderly patients with rectal cancer.