Ann Surg Treat Res.  2017 Mar;92(3):149-155. 10.4174/astr.2017.92.3.149.

Laparoscopic resection of retroperitoneal benign neurilemmoma

• Ji JH
• Park JS
• Kang CM
• Yoon DS
• Lee WJ

• KMID: 2377557
• DOI: http://doi.org/10.4174/astr.2017.92.3.149

Abstract

PURPOSE
The aim of this study was to verify that laparoscopic resection for treating retroperitoneal benign neurilemmoma (NL) is expected to be favorable for complete resection of tumor with technical feasibility and safety.
METHODS
We retrospectively analyzed 47 operations for retroperitoneal neurogenic tumor at Yonsei University College of Medicine, Severance Hospital and Gangnam Severance Hospital between January 2005 and September 2015. After excluding 21 patients, the remaining 26 were divided into 2 groups: those who underwent open surgery (OS) and those who underwent laparoscopic surgery (LS). We compared clinicopathological features between the 2 groups.
RESULTS
There was no significant difference in operation time, estimated blood loss, transfusion, complication, recurrence, or follow-up period between 2 groups. Postoperative hospital stay was significantly shorter in the LS group versus the OS group (OS vs. LS, 7.00 ± 3.43 days vs. 4.50 ± 2.16 days; P = 0.031).
CONCLUSION
We suggest that laparoscopic resection of retroperitoneal benign NL is feasible and safe by obtaining complete resection of the tumor. LS for treating retroperitoneal benign NL could be useful with appropriate laparoscopic technique and proper patient selection.

Keyword

Retroperitoneal neoplasms; Neurilemmoma; Laparoscopy

MeSH Terms

Follow-Up Studies
Humans
Laparoscopy
Length of Stay
Neurilemmoma*
Patient Selection
Recurrence
Retroperitoneal Neoplasms
Retrospective Studies

Figure

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  Fig. 1 Histologic findings of retroperitoneal neurilemmoma. (A) Retroperitoneal neurilemmoma cell had spindle shape and wavy nucleus without atypia (H&E, ×100), In immunohistocheminal stain, (B) S-100 (positive, ×200), (C) Smooth muscle actin (negative, ×200), (D) CD34 (negative, ×200) were verified.

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  Fig. 2 Preoperative image modality findings and gross appearance of retroperitoneal neurilemmoma. CT scan (A) and MRI (B) reveal 3-cm-sized encapsulated oval mass, and fluorodeoxyglucose scan (C) reveals the hypermetabolic nature of the tumor. (D) Tumor has well-circumscribed margin.

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  Fig. 3 Laparoscopic surgery of retroperitoneal neurilemmoma. (A) The tumor was located between right adrenal gland and IVC and (B) compressing the IVC to the anterior portion. (C) Cord-like structure was resected by surgical stapler. (D) The postoperative patient view. Right upper quadrant port site was used for drain placement. RNL, retroperitoneal neurilemmoma; CBD, common bile duct; IVC, inferior vena cava; Cd, cord-like structure.

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  Fig. 4 Location of retroperitoneal neurilemmoma resected by open and laparoscopic surgery. Numbers are presented as total number (open surgery/laparoscopic surgery).

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