目的:探讨经腹入路机器人辅助切除原发性腹膜后神经鞘瘤的安全性和有效性。方法:回顾性分析 2022 年 7 月—2023 年 8 月盐城市第一人民医院行机器人辅助切除原发性腹膜后神经鞘瘤的 2 例患者临床资料。观 察患者手术情况、术后随访情况及术后恢复情况。结果:2 例患者均顺利完成手术,无中转开腹,无术中输血。手 术时间分别为 110 min 和 60 min,术中出血量分别为 100 mL 和 50 mL,无严重并发症发生。随访均未见肿瘤复发。 结论:经腹入路机器人辅助切除原发性腹膜后神经鞘瘤是安全、可行的,临床值得推广。
Objective: To investigate the safety and clinical efficacy of transperitoneal robot-assisted resection of primary retroperitoneal schwannoma (PRS). Methods: The clinical data of 2 patients who underwent robot-assisted resection of PRS in the Yancheng NO.1 People`s Hospital from July 2022 to August 2023 were retrospectively analyzed. The patients’ operative status, postoperative follow-up and postoperative recovery were observed. Results: All operations were successfully completed without conversion to laparotomy or intraoperative blood transfusion. The operative time was 110 min and 60 min, and the intraoperative blood loss was 100 mL and 50 mL. No serious complications occurred in the 2 patients. All patients were followed up and no tumor recurrence was found. Conclusion: Robot-assisted resection of PRS by transperitoneal approach is safe and feasible, and worthy of clinical promotion.
收稿日期:2024-02-22 录用日期:2024-04-03
Received Date: 2024-02-22 Accepted Date: 2024-04-03
基金项目:盐城市卫健委医学科研重点项目(YK2023011)
Foundation Item: Key Project of Medical Scientific Research of Yancheng Health Committee (YK2023011)
通讯作者:查文章,Email:zhawenzhang@sohu.com
Corresponding Author: ZHA Wenzhang, Email: zhawenzhang@sohu.com
引用格式:李作安,张晓艳,潘亚奇,等 . 经腹入路机器人辅助切除原发性腹膜后神经鞘瘤的初步应用(附手术视频)[J]. 机器人 外科学杂志(中英文),2024,5(5):903-909.
Citation: LI Z A, ZHANG X Y, PAN Y Q, et al. Preliminary application of transperitoneal robot-assisted resection of primary retroperitoneal schwannomas (with surgical video)[J]. Chinese Journal of Robotic Surgery, 2024, 5(5): 903-909.
[1] Transatlantic Australasian Retroperitoneal Sarcoma Working Group. Intercontinental collaborative experience with abdominal, retroperitoneal and pelvic schwannomas[J]. Br J Surg, 2020, 107(4): 452-463.
[2] ZHANG X Y, LU L P, ZHONG Y F, et al. Comparison study of clinicopathological features of cellular schwannoma between retroperitoneum and other sites[J]. Ann Transl Med, 2022, 10(24): 1311.
[3] XIAO J C, CAI L Z, PU J, et al. Clinical characteristics and prognosis of cystic degeneration in retroperitoneal schwannoma: a retrospective study of 79 patients[J]. Cancer Med, 2023, 12(5): 5615-5629.
[4] 曲腾飞 , 邱法波 , 韩冰 , 等 . 原发性腹膜后神经鞘瘤生物学特点 及手术效果分析 [J]. 中国普通外科杂志 , 2018, 27(2): 255-260.
[5] 李文岗 , 苏昭杰 , 鲁朝敏 , 等 . 腹膜后肿瘤三维可视化精准 诊治专家共识 (2018 版 )[J]. 中国实用外科杂志 , 2018, 38(12): 1347-1353.
[6] 刘任政 , 张豪 , 孙琳 , 等 . 达芬奇机器人腹膜后肿瘤切除术 50 例临床分析 [J]. 肝胆外科杂志 , 2023, 31(1): 27-30.
[7] 汪金荣 , 何乐业 , 刘斌 , 等 . 应用达芬奇机器人切除原发性腹膜 后巨大肿瘤的临床研究 [J]. 中国内镜杂志 , 2019, 25(8): 80-84.
[8] 查立超 , 邱法波 , 韩冰 , 等 . 达芬奇机器人在原发性腹膜后肿瘤 手术中的应用 [J]. 中国微创外科杂志 , 2019, 19(7) : 597-599.
[9] 中华医学会外科学分会胰腺外科学组 , 中国抗癌协会胰腺癌 专业委员会微创诊治学组 . 腹腔镜或机器人辅助胰腺癌根治 术中国专家共识 (2022 版 )[J]. 中国实用外科杂志 , 2023, 43(2): 121-127.
[10] 《机器人肝胆胰手术操作指南》制定委员会 . 机器人肝胆胰手 术操作指南 [J]. 中华腔镜外科杂志 ( 电子版 ), 2019, 12(1): 12-27.
[11] LIU Q, GAO Y X, ZHAO Z M, et al. Robotic resection of benign nonadrenal retroperitoneal tumors: a consecutive case series[J]. Int J Surg, 2018. DOI: 10.1016/j.ijsu.2018.04.013.
[12] Al Gosaibi A, Al Mulhim A, Al Sadhan M, et al. Robotic assisted excision of a juxta renal retroperitoneal schwannoma[J]. Urol Ann, 2021, 13(3): 316-319.
[13] LIU Q, ZHOU R Q, ZHAO Z M, et al. Robotic versus open resection of benign nonadrenal retroperitoneal tumors: a propensity scorematched study[J]. Int J Surg, 2019, 65(5): 19-24.
[14] 查立超 , 邱法波 , 韩冰 , 等 . 达芬奇机器人与开腹手术治疗原 发性腹膜后肿瘤的对比研究 [J]. 中华腔镜外科杂志 ( 电子版 ), 2018, 11(6): 367-369.
[15] 中华医学会外科学分会胰腺外科学组 , 中华医学会数字医学分 会 , 中国研究型医院学会数字智能化外科专业委员会 , 等 . 胰 腺外科疾病数字智能化精准诊治中国专家共识 (2022 版 )[J]. 中 华外科杂志 , 2022, 60(10): 881-887.
[16] Dubrovin V, Egoshin A, Rozhentsov A, et al. Virtual simulation, preoperative planning and intraoperative navigation during laparoscopic partial nephrectomy[J]. Cent European J Urol, 2019, 72(3): 247-251.
[17] 段鑫鑫 , 廖文峰 , 张超 , 等 . 三维可视化重建技术在机器人辅助 肾部分切除术中的应用 [J]. 机器人外科学杂志 ( 中英文 ), 2021, 2(3): 205-212.
[18] 赵国栋 , 刘荣 . 机器人肝胆胰手术 Trocar 布置方法的教学与实 践 [J]. 中华腔镜外科杂志 ( 电子版 ), 2018, 11(3) : 166-171.
[19] Tobias-Machado M, Genes W E P, Pazeto C L, et al. Robotic-assisted surgical removal of retro peritoneal schwannoma by transmesocolic access[J]. Int Braz J Urol, 2020, 46(1): 143-144.
[20] Heinen C, Schmidt T, Kretschmer T. Decision making in retroperitoneal nerve sheath and nerve-associated tumors: a modular approach[J].Neurosurgery, 2020, 87 (3): E359-E369.
[21] 卢家俊 , 施云涛 , 史向军 , 等 . 三维可视化技术在腹膜后肿瘤切 除术中应用研究 [J]. 中国实用外科杂志 , 2019, 39(9): 959-963.
[22] 贺良 , 顾炯 , 汪雷 , 等 . 三维可视化技术在腹膜后肿瘤切除术中 应用研究 [J]. 肝胆外科杂志 , 2023, 31(4): 263-266.
[23] WU Q, LIU B Q, LU J, et al. Clinical characteristics and treatment strategy of retroperitoneal Schwannoma adjacent to important abdominal vessels: three case reports and literature review[J]. Front Surg, 2021, 14(7): 605867.