The diagnostic utility of retroperitoneoscopic tissue biopsy for unresectable retroperitoneal lesions excluding urogenital cancers.


Journal

World journal of surgical oncology
ISSN: 1477-7819
Titre abrégé: World J Surg Oncol
Pays: England
ID NLM: 101170544

Informations de publication

Date de publication:
18 Feb 2019
Historique:
received: 09 01 2019
accepted: 11 02 2019
entrez: 20 2 2019
pubmed: 20 2 2019
medline: 6 4 2019
Statut: epublish

Résumé

Retroperitoneal tumors are an uncommon disease known to consist of a diverse group of benign and malignant neoplasms. Treatment of unresectable retroperitoneal lesions requires pathological diagnosis. Here, we report the utility and safety of retroperitoneoscopic biopsy for unresectable retroperitoneal lesions excluding urogenital cancers. We analyzed 47 patients consisting of 23 (49%) and 24 (51%) cases that underwent retroperitoneoscopic tissue biopsy and open biopsy, respectively. The clinicopathological features, including postoperative complications, were compared between the two groups. Tumor pathology was diagnosed successfully with a single operation in all patients. Malignant pathology (68%) was more common than benign pathology (32%). The most common pathology was malignant lymphoma, which accounted for about 50% of all cases. There was no significant difference with respect to the age, sex, tumor size, presence of tumor-related symptom, histopathology, operative time, and complications. Three (13%) of 23 patients in the retroperitoneoscopic biopsy group received percutaneous needle biopsy before laparoscopic excisional biopsy because the evaluation of needle cores failed to confirm subclasses of diagnosed pathologies. One patient was converted to open surgery just after the initiation of operation due to severe adhesion of adjacent structures. We had two cases with iatrogenic urinoma due to ureteral injury after retroperitoneoscopic biopsy. We conclude that retroperitoneoscopic biopsy is a safe and useful tool for benign and malignant retroperitoneal lesions, in comparison to open biopsy. It is critical to carefully examine the preoperative imaging for the location of tumors, especially those close to the renal pelvis and ureter.

Sections du résumé

BACKGROUND BACKGROUND
Retroperitoneal tumors are an uncommon disease known to consist of a diverse group of benign and malignant neoplasms. Treatment of unresectable retroperitoneal lesions requires pathological diagnosis. Here, we report the utility and safety of retroperitoneoscopic biopsy for unresectable retroperitoneal lesions excluding urogenital cancers.
METHODS METHODS
We analyzed 47 patients consisting of 23 (49%) and 24 (51%) cases that underwent retroperitoneoscopic tissue biopsy and open biopsy, respectively. The clinicopathological features, including postoperative complications, were compared between the two groups.
RESULTS RESULTS
Tumor pathology was diagnosed successfully with a single operation in all patients. Malignant pathology (68%) was more common than benign pathology (32%). The most common pathology was malignant lymphoma, which accounted for about 50% of all cases. There was no significant difference with respect to the age, sex, tumor size, presence of tumor-related symptom, histopathology, operative time, and complications. Three (13%) of 23 patients in the retroperitoneoscopic biopsy group received percutaneous needle biopsy before laparoscopic excisional biopsy because the evaluation of needle cores failed to confirm subclasses of diagnosed pathologies. One patient was converted to open surgery just after the initiation of operation due to severe adhesion of adjacent structures. We had two cases with iatrogenic urinoma due to ureteral injury after retroperitoneoscopic biopsy.
CONCLUSIONS CONCLUSIONS
We conclude that retroperitoneoscopic biopsy is a safe and useful tool for benign and malignant retroperitoneal lesions, in comparison to open biopsy. It is critical to carefully examine the preoperative imaging for the location of tumors, especially those close to the renal pelvis and ureter.

Identifiants

pubmed: 30777073
doi: 10.1186/s12957-019-1581-0
pii: 10.1186/s12957-019-1581-0
pmc: PMC6379945
doi:

Types de publication

Comparative Study Evaluation Study Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

35

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Auteurs

Makito Miyake (M)

Department of Urology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan. makitomiyake@yahoo.co.jp.

Shinji Fukui (S)

Department of Urology, Yamato Koriyama Hospital, 1-62 Asahii-cho, Yamato Koriyama, Nara, 639-1013, Japan.
Department of Urology, Nara Prefecture General Medical Center, 2-897-5 Shichijo-nishi-cho, Nara, Nara, 630-8581, Japan.

Daisuke Gotoh (D)

Department of Urology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan.

Yoshiaki Matsumura (Y)

Department of Urology, Nara Prefecture General Medical Center, 2-897-5 Shichijo-nishi-cho, Nara, Nara, 630-8581, Japan.

Shoji Samma (S)

Department of Urology, Nara Prefecture General Medical Center, 2-897-5 Shichijo-nishi-cho, Nara, Nara, 630-8581, Japan.

Yoshihiro Matsumoto (Y)

Department of Urology, Hoshigaoka Medical Center, 4-8-1 Hoshigaoka, Hirakata, Osaka, 573-8511, Japan.

Hitoshi Momose (H)

Department of Urology, Hoshigaoka Medical Center, 4-8-1 Hoshigaoka, Hirakata, Osaka, 573-8511, Japan.

Shunta Hori (S)

Department of Urology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan.
Department of Urology, Saiseikai Chuwa Hospital, 323 Abe, Sakurai, Nara, 633-0054, Japan.

Shuji Watanabe (S)

Department of Urology, Saiseikai Chuwa Hospital, 323 Abe, Sakurai, Nara, 633-0054, Japan.

Takuya Owari (T)

Department of Urology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan.

Yosuke Morizawa (Y)

Department of Urology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan.

Yoshitaka Itami (Y)

Department of Urology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan.

Yasushi Nakai (Y)

Department of Urology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan.

Takeshi Inoue (T)

Department of Urology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan.

Satoshi Anai (S)

Department of Urology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan.

Kazumasa Torimoto (K)

Department of Urology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan.

Katsuya Aoki (K)

Department of Urology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan.

Nobumichi Tanaka (N)

Department of Urology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan.

Kiyohide Fujimoto (K)

Department of Urology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan.

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