ObjectiveTo evaluate the safety and feasibility of laparoscopic resection of primary retroperitoneal tumors. MethodClinical data of 52 patients diagnosed as primary retroperitoneal tumor who underwent laparoscopic resection in Peking University Third Hospital from January 2006 to December 2015 were retrospectively collected and analyzed. ResultsFifty two patients were included in the review. In 21 patients (40.3%), tumors were adjacent to major vessels (such as inferior vena cava, superior mesenteric vein, and the splenic vessel), tumors of 31 patients (59.7%) were away from major vessles. Two operations (3.8%) were converted to hand-assistant and 2 operations (3.8%) were converted to laparotomy due to tight adherence to major vessels. The mean value of operative time was 171.4-minute (60-520 minutes) and the mean value of length of incision was 2.8 cm (1-15 cm), the mean value of estimated blood loss was 86.4 mL (10-1 150 mL), 2 patients needed blood transfusion. The mean value of time of returning to diets was 1.5-day (1-5 days) and the mean value of length of postoperative hospital stay was 4.9-day (1-16 days). There was no major postoperative complications or death. Follow up was available for 47 patients at a median time of 62.0-month (4-120 months). Three patients with retroperitoneal liposarcomas experienced recurrence at 31, 34, and 48 months after operation, 1 patient with mucinous peripheral neurilemmoma experience recurrence at 69 months after operation, all of which underwent further resection, with others experiencing no recurrence or metastasis. Three patients died in reason of other diseases. ConclusionsLaparoscopic surgery can be performed safely in the treatment of primary retroperitoneal tumors, even when a tumor adjacent to major vascular structures.
ObjectiveTo summarize the experience of diagnosis and surgical treatment for solitary pulmonary nodules (SPN). MethodsWe retrospectively analyzed clinical data of 327 patients with video-assisted thoracoscopic surgery (VATS) lung resections and subsequent pathological diagnosis of the SPNs in Daping Hospital from January 2008 through May 2014 year. There were 183 males, 144 females at age of 56.6(20-79) years. ResultsOne way analysis of variance showed that there were significant differences in age, smoking index, diameter, glitches, lobulation, traction of pleural, cavity, vascular convergence, calcification between benign and malignant lesions (P<0.05). Logistic regression analysis revealed that age (P=0.004, OR=1.084), diameter (P<0.001, OR=1.467), glitches (P=0.001, OR=8.754), lobulation (P<0.001, OR=10.424), traction of pleural (P=0.002, OR=6.619) were independent predictors of malignancy in patients with SPN. Operation time was 121.4±47.6 min. Blood loss was 105.3±57.8 ml. Postoperative hospital stay was 7.3±2.4 days. Diagnostic accuracy was 99.7%. Incidence of complication was 0.5%. Five (1.5%) patients were converted to thoracotomy and no perioperative death occurred. ConclusionsAge, diameter, glitches, lobulation, traction of pleural are independent predictors of malignancy in the patients with SPN. VATS is a safe and efficient method for diagnosis and treatment of SPN.