Laparoscopic Diagnosis and Treatment of Small Bowel Tumors in 24 Patients / 中国微创外科杂志

ABSTRACT

Objective To evaluate the clinical value of laparoscopy in the diagnosis and surgical treatment of small intestinal tumors. Methods After the establishment of pneumoperitoneum with umbilicus puncture, a laparoscope was inserted.Two 5-mm trocars were placed through lateral right and left rectus abdominis to explore the location of the small intestine tumors.A 3 -4 cm incision was made along the abdominal midline or lower abdomen median.With the use of incision protector,benign tumors were given local excision of small intestine,or malignant tumors were given radical resection.End to end or side to side anastomosis of bowel was carried out,and then the mesenteric hole was closed and the puncture hole sutured. Results All the patients were diagnosed and treated by laparoscopic procedure successfully, including 23 cases of laparoscopic-assisted partial intestinal resections and 1 case of right hemicolectomy.The mean operative time was(70.3 ±21.7)min,the mean blood loss was(18.5 ±3.1)ml,the mean length of incision was(3.5 ±1.1)cm, and the mean time for passage of flatus was(2.5 ±0.5)d.Postoperative pathological examinations showed benign tumors in 8 cases,most of which were leiomyoma(5 cases), and malignant tumors in 16 cases, most of which were stromal tumors(6 cases).The postoperative hospital stay was(6.5 ±2.5)d.Follow-ups were conducted for 0.5-4.5 years(mean, 2.6 years)in 19 cases,including 6 cases of benign tumor and 13 cases of malignant tumor.No recurrent tumor was found except one fatal case of advanced intestinal carcinoma. Conclusion Laparoscopic exploration can diagnose small intestinal tumors accurately, and laparoscopic-assisted surgical treatment is safe.