Curved incision under the costal margin in retroperitoneal tumor surgery

This study was conducted to investigate the value of using a curved incision under the costal margin in retroperitoneal tumor surgery. Data on 68 patients with retroperitoneal tumors were reviewed. Of the 68 patients, 32 underwent tumor removal via a curved incision under the costal margin (group A) and the remaining 36 patients underwent a mid-abdominal oblique incision at the waist (group B). The patient outcomes were compared between the two groups to analyze the effects of the different types of incision on the completeness of resection, duration of operation, intraoperative blood loss, postoperative recovery time and surgical complications. The tumors from the 32 patients in group A were all successfully removed and the outcomes of the patients in group A, regarding tumor removal, duration of operation, amount of blood lost and surgical complications, were superior to those of the patients in group B. A route of incision is required that adequately exposes the internal limit or lower boundary of the tumor and ensures adequate surgical field visualization. The 32 patients underwent retroperitoneal tumor removal via a curved incision under the costal margin, plus a longitudinal incision along the lower boundary of the tumor at the midline of the abdomen. All the patients underwent complete tumor resection and recovered well after surgery, without necrosis at the incision site. In terms of duration of the operation, blood transfusion volume, mean length of hospital stay, weight of tumor removed, perioperative mortality, postoperative intestinal fistulas and rate of complete surgical resection, the outcomes of the patients in group A were superior to those of group B.