Purpose: Retroperitoneal neural tumor (RNT) is rarely excised laparoscopically, and the laparoscopic management of RNT remains controversial. We herein report 4 cases of laparoscopic excision of RNT that resulted in diverse clinical outcomes. Patients and Methods: Between August 2005 and January 2011, we performed laparoscopic excision of RNT in 4 patients. The mean tumor size was 4.5 cm. The mean operative time was 297 minutes and the mean amount of blood loss was 55 ml. The surgeries were uneventful, with no operative complications or evidence of intra-abdominal bleeding. However, 2 patients required reoperation for delayed hemorrhage and urinoma formation, respectively. Results: The postoperative pathological diagnoses were schwannoma in 3 patients and ganglioneuroblastoma in 1 patient. All patients were well with no signs of peripheral neuropathy or radiculopathy, and CT and/or 18F-FDG PET/CT performed during follow-up indicated no evidence of disease. Conclusions: Obtaining extensive preoperative knowledge of the source neural and vascular anatomy of the tumor is important for the surgical planning of laparoscopic resection of RNT. When a great deal of care is taken to divide the tumor and the source nerves and vital vessels, safe execution of RNT can be achieved for minimal postoperative mortality and morbidity.

Keywords:
Laparoscopy, Retroperitoneal neural tumor, Schwannoma, Ganglioneuroblastoma
1.
Shindo S, Motohashi S, Katsu M, Kaga S, Inoue H, Matsumoto M, Kono K, Fujii H, Takeda M: Treatment of abdominal malignancy invading the vena cava: a report of seven cases. Surg Today 2007;37:685-689.
2.
Das Gupta TK, Brasfield RD, Strong EW, Hajdu SI: Benign solitary Schwannomas (neurilemomas). Cancer 1969;24:355-366.
3.
Daneshmand S, Youssefzadeh D, Chamie K, Boswell W, Wu N, Stein JP, Stein JP, Boyd S, Skinner DG: Benign retroperitoneal schwannoma: a case series and review of the literature. Urology 2003;62:993-997.
4.
Tortorelli AP, Papa V, Rosa F, Pacelli F, Doglietto GB: Image of the month-retroperitoneal schwannoma. Arch Surg 2006;141: 1259-1261.
5.
Ningshu L, Min Y, Xieqiao Y, Yuanqing Y, Xiaoqiang M, Rubing L: Laparoscopic management of obturator nerve schwannomas: experiences with 6 cases and review of the 12 literature. Surg Laparosc Endosc Percutan Tech 2012;22:143-147.
6.
Lacarriere E, Le Long E, Caremel R, Grise P: Removal of pelvic schwannoma using a retroperitoneoscopic and open double approach: description of an effective novel technique. J Laparoendosc Adv Surg Tech A 2012;22:269-272.
7.
Seo I Y, Boldbaatr Y, Choi KH: Laparoscopic resection of ancient schwannoma embedded in the psoas muscle. Surg Laparosc Endosc Percutan Tech 2011;21:e336-338.
8.
Pazouki A, Khalaj A, Shapoori P, Vaziri M, Najafi L: Laparoscopic resection of a retroperitoneal schwannoma. Surg Laparosc Endosc Percutan Tech 2011;21:e326-328.
9.
Gorgun M, Sezer TO, Kirdok O: Laparoscopic resection of retroperitoneal schwannoma near the inferior vena. Ann Vasc Surg 2010;24:551.e1-4.
10.
Sasaki A, Suto T, Nitta H, Shimooki O, Obuchi T, Wakabayashi G: Laparoscopic excision of retroperitoneal tumors: report of three cases. Surg Today 2010;40:176-180.
11.
Yoshino T, Yoneda K: Laparoscopic resection of a retroperitoneal ancient schwannoma: a case report and review of the literature. Anticancer Res 2008;28:2889-2891.
12.
Melvin WS: Laparoscopic resection of a pelvic schwannoma. Surg Laparosc Endosc 1996;6:489-491.
13.
Descazeaud A, Coggia M, Bourriez A, Goeau-Brissonniere O: Laparoscopic resection of a retroperitoneal schwannoma. Surg Endosc 2003;17:520.
14.
Koike K, Iihara M, Kanbe M, Omi Y, Aiba M, Obara T: Adult-type ganglioneuroblastoma in the adrenal gland treated by a laparoscopic resection: report of a case. Surg Today 2003;33:785-790.
15.
Slapa RZ, Jakubowski W, Kasperlik-Zaluska AA, Szopinski K, Debski R, Samsel M, Polanski J, Borowicz K: Adrenal ganglioneuroblastoma in pregnant woman: diagnosis with three-dimensional ultrasound. Eur Radiol 2002:12:S121-126.
16.
Nakazato Y, Hosaka N: A 32-year-old man with left temporal lobe tumor. Neuropathology 2004;24:261-262.
17.
Gunlusoy B, Arslan M, Selek E, Sural S, Ayder AR: A case report: adrenal ganglioneuroblastoma in a 59-year old man. Int Urol Nephrol 2004;36:481-483.
18.
Kurt E, Filiz G, Vuruskan H, Kurt M, Evrensel T: Life-threatening complications of an extremely rare tumor of the kidney: adult-type primary renal ganglioneuroblastoma. South Med J 2007;100:852-853.
19.
Nishihara H, Ozaki Y, Ito T, Yoshinaga T, Tabu K, Tanino M, Nagashima K, Tanaka S: A case of cerebral ganglioneuronal tumor in the parietal lobe of an adult. Brain Tumor Pathol 2008;25:45-49.
20.
Mizuno S, Iida T, Fujita S: Adult-onset adrenal ganglioneuroblastoma - bone metastasis two years after surgery: report of a case. Surg Today 2010;40:482-486.
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2013
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