Giant retroperitoneal tumor successfully resected by reoperation after caesarean section

The patient is a female, 50 years old, found abdominal tumor for 2 months on April 8, 2008 in a famous large hospital in China for cesarean section, due to the huge tumor, wide base and fixed, only tumor excision biopsy was performed. After the surgery, the tumor was treated with interventional therapy, Hai Fu Knife, and thermotherapy, but the rapid growth of the tumor could not be controlled. Review CT 2 months later found that the tumor diameter increased from the original 17 cm to 30 cm. The huge tumor compression seriously affected the patient’s daily life, and even eating became difficult. The patient’s family was very anxious, and the patient’s husband, after consulting experts (including inviting experts from Beijing and Shanghai for consultation) and browsing interconnected websites, resolutely decided to travel thousands of miles to our hospital for treatment. After re-examining the tumor with CT and MRI, it was found that the size of the tumor had increased several times compared with the first surgery, occupying almost the whole abdominal cavity, topping the septum muscle and reaching the pelvic inlet, together with the adhesion caused by the first surgery, the surgery was even more difficult than moving a mountain. After careful study of the imaging data, I found that there was still hope for resection of the tumor! The patient’s family requested that even if complete resection was not possible, partial resection would be fine. The hope, trust and understanding of the patient’s family gave us great encouragement. Therefore, we decided to prepare the patient for surgery as soon as possible and perform another surgery to remove the tumor. After adequate pre-surgical preparations (large amount of blood products, vascular surgical instruments, argon gas-enhanced electrosurgical knife, blood transfusion apparatus, etc.), surgery was performed on June 13th. During surgery, the tumor was found to encircle the pancreas, splenic vessels, and large intestine, and was densely adherent to the diaphragm and the original surgical incision. The tumor trophoblastic vessels were thick and thin-walled, and bleeding was like a fountain if there was a little carelessness. With the close cooperation of anesthesiologists, the tumor and the spleen, the tail part of the pancreas, the left half of the colon and part of the stomach encircled by the tumor were successfully resected in one piece after nearly 10 hours of struggle and the digestive tract was reconstructed, and the patient passed through the surgery successfully.