Experience of delivery resection surgical policies of giant tumor in retroperitoneal adrenal region:a report of 24 cases
Objective:To explore the experience and method of three-step delivery surgery for the treatment of giant tumors in the retroperitoneal adrenal region.Methods:A retrospective analysis was conducted on the clinical data of 24 patients with retroperitoneal adrenal tumors with a tumor diameter ≥10 cm admitted to Jiangxi Cancer Hospital from July 2013 to December 2020.The surgical treatment strategy was a three-step delivery method.A-mong them,there were 17 males and 7 females,with an average age of(54±17)years.The average size of the tumor was(17.6±6.4)cm,located in 11 cases on the left and 13 cases on the right.Surgical treatment strategy:The first step is to open the lateral peritoneum,free the loose tissue around the tumor,expand the gap,and dis-sect the relationship between the tumor and adjacent organs;The second step is to lift and pull the tumor outwards and downwards,accurately handle the relationship between the tumor and important blood vessels and organs,and"deliver"the tumor;The third step is to strictly stop bleeding on the wound and check for damage to nearby organs.The surgical time,bleeding volume,blood transfusion volume and pathological results were analyzed,and survival follow-up was conducted.Results:All 24 surgeries in this study were successfully completed,with surgi-cal time of(300±84)min,intraoperative bleeding of(1 018±965)mL.Tumors were completely resected in 20 cases,and the other four cases experienced block resection and residual tumor.Multiple organs were resected in 15 cases,involving kidney in 12 cases,spleen in 6 cases,pancreas in 5 cases,intestine in 2 cases,stomach in 1 case,gallbladder in 1 case,and liver in 1 case.Pathology results showed that 20 cases were malignant tumors,and 4 cases were benign tumors,including 11 cases of liposarcoma,3 cases of inflammatory myofibroblastoma,2 cases of adrenal cortical carcinoma,1 case of choriocarcinoma,1 case of seminoma,1 case of adrenal ganglioneu-roblastoma,1 case of adrenal neuroblastoma,2 cases of paraganglioma,1 case of solitary fibroma,and 1 case of pheochromocytoma.All patients recovered well and were discharged.The median follow-up time for malignant tumors was 50.5 months,and the overall survival rates at 1 year,3 years,and 5 years were 90.0％,74.4％,and 51.6％,respectively.Conclusion:The three-step delivery method for the treatment of giant tumors in the retro-peritoneal adrenal region is simple and effective with fewer complications,so is worth promoting.
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