Dr Shinnosuke Nagano and colleagues from the Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Osaka, Japan recently reported an interesting case report of the treatment of nonadrenal ganglioneuromas done by Laparoscopic resection.
The study is published in the International Journal of Surgery Case Reports.
Ganglioneuromas are well-differentiated benign tumors that arise from sympathetic ganglion cells. Ganglioneuromas are difficult to diagnose preoperatively, so surgical complete resection combined with diagnostic treatment is recommended. In ganglioneuromas of the retroperitoneum, nonadrenal cases are resected by laparotomy due to the proximity to major vessels. There have been few reports of laparoscopic resection for retroperitoneal paraaortic ganglioneuromas.
However, the authors reported the present study wherein they studied a case of a 49-year-old female patient who presented with epigastric pain in which laparoscopic resection was required for a 90-mm ganglioneuroma adhered to the aorta and inferior mesenteric artery.
On Computed tomography scan, the authors observed a 90 mm retroperitoneal tumor, partially located between the aorta and inferior mesenteric artery. A definitive diagnosis was not obtained, and laparoscopic excision of the retroperitoneal tumor was performed transabdominally. The patient recovered without postoperative complications and left the hospital on a postoperative day 8. Postoperative pathological findings revealed a ganglioneuroma from the abdominal periaortic plexus.
Thereafter, the literature revealed that the nonadrenal ganglioneuromas resected laparoscopically using a transabdominal approach was mostly observed in individuals with a median age of 33 years with the median tumor size being 50 mm. Regarding the surgical results, the median operative time was 170.5 min, median blood loss was 21.5 mL, and the median postoperative stay was 7 days.
Hence, the authors concluded that "laparoscopic resection of nonadrenal ganglioneuromas are feasible even when a tumor adheres to major blood vessels if there is no evidence of local invasion or malignancy on the basis of various preoperative examinations."
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https://doi.org/10.1016/j.ijscr.2020.11.127