PDF(Pubmed)
Abstract：
UNASSIGNED: Resection of a giant retroperitoneal liposarcoma is difficult and technically demanding, especially for large retroperitoneal tumors accompanied by a diaphragmatic hernia. Technically, the open abdominal approach can be time-consuming and difficult to perform, with possible intraoperative complications and other factors bringing psychological and physical difficulties to the patient. This study reports a safe and feasible approach for the complete resection of a large retroperitoneal tumor complicated by a diaphragmatic hernia.
UNASSIGNED: A 58-year-old male patient with persistent upper abdominal pain and distension was treated at a local hospital on 4 July 2022. Computed tomography showed a mixed-density mass on the right retroperitoneum, and liposarcoma was considered. On 6 July 2022, the patient was transferred to our hospital for further treatment. Computed tomography showed a mass with low-density fatty shadow in the right adrenal region. The boundary with the right adrenal gland was unclear. The mass was 102 mm × 74 mm, and the right lobe of the liver was compressed. Insufficiency of the right middle lobe of the liver was seen due to a right diaphragmatic hernia and left mediastinal deviation. We considered the traditional approach for tumor resection via laparotomy, but we opted to perform a comprehensive evaluation first. The tumor was close to the back of the right kidney and liver, causing the diaphragm to rise because of its proximity to these organs. Exposing the tumor through laparotomy would be difficult, making it challenging to remove. The patient had a diaphragmatic hernia and moderate pulmonary dysfunction; therefore, we decided to enter the abdomen through a thoracotomy of the ninth rib.
UNASSIGNED: Using our technique, the tumor was easily visualized and completely removed in approximately 30 min. The intraoperative blood loss was 100 ml, and no postoperative bleeding, pneumothorax, intestinal fistula, infection, or other complications occurred.
UNASSIGNED: The transthoracic approach may be a safer and more feasible resection method than the traditional open approach for patients with giant retroperitoneal liposarcoma with a diaphragmatic hernia.
UNASSIGNED: A 58-year-old male patient with persistent upper abdominal pain and distension was treated at a local hospital on 4 July 2022. Computed tomography showed a mixed-density mass on the right retroperitoneum, and liposarcoma was considered. On 6 July 2022, the patient was transferred to our hospital for further treatment. Computed tomography showed a mass with low-density fatty shadow in the right adrenal region. The boundary with the right adrenal gland was unclear. The mass was 102 mm × 74 mm, and the right lobe of the liver was compressed. Insufficiency of the right middle lobe of the liver was seen due to a right diaphragmatic hernia and left mediastinal deviation. We considered the traditional approach for tumor resection via laparotomy, but we opted to perform a comprehensive evaluation first. The tumor was close to the back of the right kidney and liver, causing the diaphragm to rise because of its proximity to these organs. Exposing the tumor through laparotomy would be difficult, making it challenging to remove. The patient had a diaphragmatic hernia and moderate pulmonary dysfunction; therefore, we decided to enter the abdomen through a thoracotomy of the ninth rib.
UNASSIGNED: Using our technique, the tumor was easily visualized and completely removed in approximately 30 min. The intraoperative blood loss was 100 ml, and no postoperative bleeding, pneumothorax, intestinal fistula, infection, or other complications occurred.
UNASSIGNED: The transthoracic approach may be a safer and more feasible resection method than the traditional open approach for patients with giant retroperitoneal liposarcoma with a diaphragmatic hernia.
摘要：
■切除巨大的腹膜后脂肪肉瘤是困难和技术要求高的，尤其是伴有膈疝的大型腹膜后肿瘤。从技术上讲,开腹手术既费时又困难,可能的术中并发症和其他因素给患者带来心理和生理困难。这项研究报告了一种安全可行的方法，可以完全切除伴有diaphragm肌疝的大型腹膜后肿瘤。
■2022年7月4日，一名58岁的男性患者持续上腹部疼痛和腹胀在当地医院接受治疗。计算机断层扫描显示右侧腹膜后有混合密度肿块，考虑了脂肪肉瘤。2022年7月6日，患者被转移到我们医院接受进一步治疗。计算机断层扫描显示右肾上腺区域有一个带有低密度脂肪影的肿块。与右肾上腺的边界不清楚。质量为102毫米×74毫米，肝脏右叶被压缩.由于右diaphragm肌疝和左纵隔偏斜，可见肝脏右中叶功能不全。我们认为通过剖腹手术切除肿瘤的传统方法，但是我们选择先进行全面评估。肿瘤靠近右肾和肝脏的后部，导致隔膜上升，因为它靠近这些器官。通过剖腹手术暴露肿瘤会很困难，很难移除。患者有膈疝和中度肺功能障碍；因此，我们决定通过第九根肋骨的开胸手术进入腹部。
■使用我们的技术，肿瘤很容易可视化，并在大约30分钟内完全切除。术中出血量为100ml,术后没有出血,气胸,肠瘘,感染,或其他并发症发生。
■对于伴有膈疝的巨大腹膜后脂肪肉瘤患者，经胸入路可能比传统的开放入路更安全，更可行的切除方法。
■2022年7月4日，一名58岁的男性患者持续上腹部疼痛和腹胀在当地医院接受治疗。计算机断层扫描显示右侧腹膜后有混合密度肿块，考虑了脂肪肉瘤。2022年7月6日，患者被转移到我们医院接受进一步治疗。计算机断层扫描显示右肾上腺区域有一个带有低密度脂肪影的肿块。与右肾上腺的边界不清楚。质量为102毫米×74毫米，肝脏右叶被压缩.由于右diaphragm肌疝和左纵隔偏斜，可见肝脏右中叶功能不全。我们认为通过剖腹手术切除肿瘤的传统方法，但是我们选择先进行全面评估。肿瘤靠近右肾和肝脏的后部，导致隔膜上升，因为它靠近这些器官。通过剖腹手术暴露肿瘤会很困难，很难移除。患者有膈疝和中度肺功能障碍；因此，我们决定通过第九根肋骨的开胸手术进入腹部。
■使用我们的技术，肿瘤很容易可视化，并在大约30分钟内完全切除。术中出血量为100ml,术后没有出血,气胸,肠瘘,感染,或其他并发症发生。
■对于伴有膈疝的巨大腹膜后脂肪肉瘤患者，经胸入路可能比传统的开放入路更安全，更可行的切除方法。
