AB132. Surgical techniques for resection of large tumors in the left upper quadrant of the abdomen

OBJECTIVE: The surgical resection of large tumors on the left upper quadrant of the abdomen is a technical challenge to the urologist, often because of poor surgical exposure and severe complications and even death. We use a surgical technique, en bloc mobilization of the pancreas and spleen to facilitate resection of large tumors. METHODS: From June 2012 to March 2014, en bloc mobilization of the pancreas and spleen was used in 6 patients with giant tumor in the upper left quadrant of the abdomen. Among them, 3 cases of adrenal tumor, 3 cases of left renal tumor (2 cases of renal cell carcinoma, 1 case hamartoma), 1 case with left renal vein tumor thrombus. The amount of blood loss, blood transfusion rate, and postoperative complications were recorded. RESULTS: The mean blood loss was 350 mL. In the operation, there were two cases of the small area of the splenic capsule injured, which was repaired, and the splenectomy was not performed. No patient died of perioperative mortality, acute pancreatitis or acute renal insufficiency, no deep venous thrombosis. CONCLUSIONS: For patients with large tumors in the left upper quadrant of the abdomen, en bloc mobilization of the pancreas and spleen can provide the best exposure and a powerful guarantee for the safety of operation.