Retroperitoneal teratoma resection

Retroperitoneal teratoma resection for the surgical treatment of retroperitoneal tumors. Teratomas are also common retroperitoneal tumors in children and are composed of primitive embryonic tissues. It generally contains three embryonic leaf tissues, wherein the ectoderm contains teeth, skin and nerve tissue; the mesoderm contains connective tissue, vascular tissue, and the endoderm contains the respiratory tract and the digestive tract epithelium. Teratomas are divided into benign and malignant types. The components of benign teratoma are composed of differentiated and mature tissues. Sometimes in a benign teratoma, both mature and differentiated tissues are mixed together. The latter has the original tissue characteristics of the embryo and has a potential malignant tendency. Malignant teratoma has a metaplastic nature. Teratomas are both cystic and substantial. Sometimes a part of a tumor is cystic and the other part is substantial. Substantial teratoma is more likely to be malignant. Malignant hemorrhage and necrosis in the tumor are mostly malignant. Benign teratomas have an envelope that grows parallel to the rate of development of the sick child. Malignant teratomas grow rapidly and infiltrate with surrounding tissues and even metastasize. Treating diseases: teratoma Indication After the diagnosis of retroperitoneal teratoma is established, regardless of the size and extent of the tumor, active surgical treatment should be performed. Preoperative preparation Preoperative preparation of the same nephroblastoma. Large tumors should be prepared for bowel surgery before surgery, in case of partial colonectomy. Blood should be prepared before surgery. Fasting in the morning of surgery, place the stomach tube. Surgical procedure 1. Incision: more abdominal incision is used, with the mass as the center, and if necessary, cross the midline. The retroperitoneal teratoma is often large and adheres to the kidney, abdominal aorta, inferior vena cava, pancreas, and spleen, so the incision should be large enough to achieve good exposure. Some doctors also advocate the longitudinal incision of the rectus abdominis (Fig. 12.19.3-1). 2. If it is a huge cystic teratoma, after the laparotomy, after a part of the tumor is revealed, the needle is puncture with a thick needle, and the cyst fluid is slowly released. Slow discharge of fluid in the tumor allows the sick child to gradually adapt to changes in intra-abdominal pressure. After the tumor is reduced, it is easy to be separated from the surrounding organs for easy removal. Sometimes a large retroperitoneal teratoma can occupy most of the abdominal cavity. At this time, the peritoneum should be cut from the outside of the ascending colon or descending colon, and then the ascending colon or descending colon. Care is taken to protect the vascular arch of the mesentery (Figure 12.19.3-2). The benign teratoma has a complete capsule. During the operation, the blood supply to the tumor can be ligated outside the capsule, and then the surrounding organs and large blood vessels are gradually separated. Generally, there is no major difficulty. However, malignant tumors have no capsule and are closely adhered to and infiltrated with surrounding organs and large blood vessels. Pay special attention to the location of the inferior vena cava when separating the tumor, sometimes in front of the tumor, and sometimes push it to one side. When the tumor is free, the blood vessels in the root of the mesentery are also protected to prevent damage. If the pancreas adheres to the tumor, it can be peeled off sharply. In the process of resection of the tumor, due to large wounds, extensive oozing, and easy to cause hemorrhagic shock, surgery should be timely supplemented with whole blood. If shock has occurred, the blood transfusion rate should be accelerated, the tumor should be suspended, and the operation should be continued after the blood pressure rises. When the tumor adheres to the kidney, if the contralateral kidney functiones well, the kidney can be removed. If the tumor is derived from the ovary, the ovary should be removed; if the adhesion between the tumor and the abdominal aorta is difficult to separate, a part of the tumor may be left in order to preserve life and prevent fatal bleeding. 3. When removing a large solid tumor, it should also be carried out relatively slowly to prevent shock from sudden decrease in abdominal pressure. Postoperative diet 1. Give high protein, high vitamin and cellulose-rich digestible diet. 2, do not eat spicy spicy food.