对于威尔姆斯瘤的腹腔镜脏节约手术和腹腔镜脏切除术
Maciej Murawski1, Joanna Stefanowicz2,3,4, Marcin Łosin1
1Department of Surgery and Urology for Children and Adolescents, Faculty of Medicine, Medical University of Gdansk, Gdansk, Poland.
概括
laparoscopic nephrectomy (LN) 是治疗儿童威尔姆斯瘤的一个可行的选择,尤其是在新辅助化疗缩小瘤后. 经验丰富的外科医生可以通过这种微创方法获得良好的结果.
科学领域:
- 儿科手术 儿科手术
- 尿道瘤学 尿道瘤学
- 最少侵入性的手术
背景情况:
- 对于威尔姆斯瘤的 laparoscopic nephrectomy (LN) 仍然是有争议的.
- 新辅助化疗促进瘤缩,使得LN成为一个可行的选择.
- laparoscopic 脏节约手术 (NSS) 是技术上要求高昂的,需要外科医生的专业知识.
研究的目的:
- 报告关于腹腔镜手术对威尔姆斯瘤的可行性和结果.
- 评估新辅助化疗在腹腔镜切除前减少瘤大小的有效性.
主要方法:
- 在2013年至2020年期间,对8名患有威尔姆斯瘤的儿科患者进行了腹腔镜手术 (7次切除术,1次半切除术) 的回顾性评估.
- 所有患者都按照SIOP协议接受了新辅助化疗.
- 在化疗前后测量瘤体积.
主要成果:
- 七次腹腔镜瘤切除术和一个腹腔镜半瘤切除术成功进行,没有发生手术内破裂.
- 尿泄漏的一个案例发生在血淋巴切除术后;没有报告其他并发症.
- 所有8名患者均保持无疾病,没有局部或远程复发,随访时间中位数为71个月.
结论:
- laparoscopic nephrectomy 是对儿科威尔姆斯瘤的一种可行的手术选择.
- 仔细选择患者和专门的腹腔镜外科培训对于成功的结果至关重要.
- laparoscopic heminephrectomy 需要特殊的外科技能和经验.
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