The Comparative Study Of Laparoscopy And Open Surgical Treatment By Intraperitoneal Approach Of Primary Retroperitoneal Tumor

Objective: By comparing the clinical data of laparoscopic surgery via transabdominal approach and open surgery for primary retroperitoneal tumors through retrospective analysis,the safety and effectiveness of laparoscopic surgery via transabdominal approach for primary retroperitoneal tumors were preliminarily observed.Methods:The clinical data of 103 cases of retroperitoneal tumor in our hospital from January 2011 to June 2017 were retrospectively analyzed.Among them,29 cases underwent laparoscopic surgery(group laparoscopy)and 74 underwent open surgery(group open).Subgroup analysis was performed according to the characteristics and the size of tumors.A retrospective analysis was performed comparing the basic data(sex,age,BMI,tumor size,pathological type,whether closing or invading important organs or large blood vessels),intraoperative and postoperative indicators(operation time,intraoperative blood loss,postoperative feeding time,postoperative hospitalization time,postoperative complications,hospitalization expenses)between laparoscopic group and open group.Results:In subgroup of cystic tumor,intraoperative blood loss[57.5(42.0)ml vs 100.0(150.0)ml,P<0.05]and postoperative hospitalization time[5.0(2.8)d vs 9.0(4.5)d,P<0.05] in group laparoscopy(n=14)were less compared with group open(n=13).There was no statistically difference(P>0.05)between the two groups in terms of operation time[167.5(61.3)min vs 150.0(67.2)min],postoperative feeding time[3.0(2.0)d vs 4.0(3.5)d],the incidence of postoperative complications[O% vs 7.7%],hospitalization expenses[28090.0(10479.0)yuan vs 24904.8(8195.9)yuan].In the subgroup of non-cystic tumor with size ?6cm,intraoperative blood loss[50.0(90.0)ml vs 100.0(210.5)ml,P<0.05],postoperative hospitalization time [6.0(5.0)d vs 11.0(4.0)d,P<0.05]and the incidence of postoperative complications [14.3% vs.46.7%] in group laparoscopy(n=7)were less compared with group open(n=15).There was no statisticallydifference(P>0.05)between the two groups in terms of operation time[151.5(70.0)min vs148.4(85.0)min],postoperative feeding time[2.0(1.0)d vs 4.0(2.0)d],hospitalization expenses[31730.5(10312.0)yuan vs 33902.4(12081.8)?].In the subgroup of non-cystic tumor with size>6cm,there was no statistical difference(P>0.05)between group laparoscopy(n=8)and group open(n=46)in terms of operation time[242.5(181.0)min vs 229.8(138.9)min]?intraoperative blood loss[340.0(375.0)ml vs 400.0(357.0)ml],postoperative feeding time[2.0(1.0)d vs3.0(2.0)d],postoperative hospitalization time[8.0(5.8)d vs 11.5(7.2)d],the incidence of postoperative complications[25.0% vs 26.1%],hospitalization expenses[38099.5(16463.1)yuan vs 40955.2(16919.2)yuan].Conclusions : 1.The choice of surgical procedures for primary retroperitoneal tumors should be based on the nature and size of the tumor and the clinical experience of the surgeon;2.Transperitoneal approach for laparoscopic retroperitoneal tumor resection is safe and feasible,especially for cystic and small retroperitoneal tumors.