Clinical efficacy of laparoscopic resection for retroperitoneal tumor via transabdominal approach

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) follow-up and survival situations. Follow-up using outpatient examination and telephone interview was performed to detect postoperative 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, postoperative gastrointestinal recovery time, postoperative drainage-tube removal time and duration of postoperative 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 postoperative complications including 2 of chylous fistula and 1 of delayed gastric emptying were improved by symptomatic treatment. There was no perioperative death. (2) Follow-up and survival situations: 37 patients were followed up for 3-82 months, with a median time of 30 months. During the follow-up, 1 patient with inflammatory myofibroblastic tumor had recurrence at 15 months postoperatively 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. Key words: Retroperitoneal neoplasms; Surgical procedures, operative; Laparoscopy; Approach