• <tr id="yyy80"></tr>
  • <sup id="yyy80"></sup>
  • <tfoot id="yyy80"><noscript id="yyy80"></noscript></tfoot>
  • 99热精品在线国产_美女午夜性视频免费_国产精品国产高清国产av_av欧美777_自拍偷自拍亚洲精品老妇_亚洲熟女精品中文字幕_www日本黄色视频网_国产精品野战在线观看 ?

    Removal of pediatric stage IV neuroblastoma by robot-assisted laparoscopy:A case report and literature review

    2019-08-14 09:22:34DiXiangChenYiHanHouYaNanJiangLiWeiShaoShanJieWangXianQiangWang
    World Journal of Clinical Cases 2019年12期

    Di-Xiang Chen,Yi-Han Hou,Ya-Nan Jiang,Li-Wei Shao,Shan-Jie Wang,Xian-Qiang Wang

    Abstract

    Key words: Robot-assisted surgery; Retroperitoneal neuroblastoma; Children; Case report

    INTRODUCTION

    Neuroblastoma (NB) is a highly heterogeneous tumor.Some tumors can spontaneously subside without treatment.However,most tumors are occult and rapidly metastasize throughout the body,ultimately becoming life-threatening.Surgical resection is an effective treatment for children with NB.Minimally invasive surgery has unique advantages in NB resection,and case reports of laparoscopic NB resection confirm its safety and feasibility[1].Robot-assisted laparoscopic surgery is a new method and is superior to conventional laparoscopic surgery,which has been preliminarily applied in clinical practice,yielding significant curative effects[2].This method can further promote the resection of pediatric tumors in a minimally invasive manner.

    Robot-assisted surgery has been widely used in adult surgery,including general surgery[3-5],urinary surgery[6-8],and cardiac surgery[9-11].Currently,robot-assisted systems,either alone or in combination with laparoscopic surgery,have been relatively mature in adult surgery,especially in the field of urology[12].There are many retrospective clinical case reports comparing the safety and efficacy of robotic surgery in adult surgery through randomized controlled studies[13-15],which have confirmed its safety and feasibility.

    Compared with adults,the age,physio-pathological conditions,and lesion location of children are unique and complex,rendering the advantages of robot-assisted surgery more prominent in the field of pediatric surgery.Pediatric surgeries involving the abdominal cavity,pelvic cavity,and thoracic cavity have been reported in China and abroad[16-18].It is confirmed that with robot-assisted systems,pediatric surgery is safe and feasible.

    In the field of pediatric NB,Yuet al[1]from the University of Oklahoma reported the first robot-assisted resection of pediatric NB in theJournal of Robotic Surgeryin 2014.In that study,the prenatal ultrasound already suggested bilateral hydronephrosis in the patient,and a left adrenal gland mass with a size of 2.5 cm × 1.5 cm was found in the subsequent examinations.Therefore,when the patient was 15 mo old,robotic-assisted left adrenal gland mass resection and ipsilateral retroperitoneal lymph node dissection were performed.The transumbilical approach was used to perform the surgery.The robotic cannula was placed and the surgery was successfully performed using the Da Vinci robotic system.Pathological examination confirmed that the tumor was an NB (stage 2b).The patient did not have intraoperative or postoperative complications and was discharged 24 h after surgery.The patient resumed all activities within one week after the surgery,and no signs of recurrence were found during the regular postoperative follow-ups.This case shows that,compared with open surgery,robot-assisted surgery can not only successfully yield the same oncological results but also help reduce the disease recurrence rate and shorten the durations of surgery,hospitalization stay,and postoperative recovery.

    Zhuet al[19]from Tongji Hospital of Huazhong University of Science and Technology reported the application of a robotic surgical system in the surgical treatment of pediatric NB in 2017 in China.The outcomes of three cases of pediatric adrenal pheochromocytoma treated using the Da Vinci robot system were reported.Among the patients,one was male and the other two were female,with an average age of 5.2 years.The tumors were all on the right side,with a size of (2.0-3.6) cm × (1.0-3.6) cm.The Da Vinci robotic system was used to successfully complete the surgery,and the robotic surgery advantages of minimal trauma and quick recovery were confirmed.The study by Zhuet al[19]provided practical experience in applying robot-assisted surgery in the field of pediatric NB resection.

    We successfully completed a stage IV pediatric NB resection using the Da Vinci Si robot system.The purpose of this study was to explore the feasibility and effectiveness of robotic surgery in the treatment of complicated NB in children and to summarize the preliminary experience in applying this technique.

    CASE PRESENTATION

    Chief complaints

    The patient was a girl aged 3 years and 5 mo.At the end of 2017,the patient was admitted due to abdominal discomfort,and a mass in the right upper quadrant of the abdomen was found.After supraclavicular lymph node biopsy,the patient was diagnosed with stage IV retroperitoneal NB.After chemotherapy (four cycles),the tumor shrank significantly,but the primary tumor behind the inferior vena cava remained.

    Physical examination

    The abdomen was soft,without tenderness,rebound pain,or an obvious mass.The liver and spleen were impalpable,Murphy's sign was negative,and the bowel sounds were normal.

    Laboratory examinations

    The laboratory values were the following:Serum ferratin,1957.00 ng/mL; alanine transaminase,31.2 U/L; aspartate transaminase,38.9 U/L; alkaline phosphatase,165.2 U/L; urea,3.06 mmol/L; SCr,33.4 μmol/L; hemoglobin,87 g/L; red blood cell count,2.78 × 1012/L; and white blood cell count,9.24 × 109/L.

    Imaging examination

    Before chemotherapy,abdominal enhanced computed tomography showed a middle line retroperitoneal neoplasm with the inferior vena cava,right renal vessels,and abdominal aorta traversing in it.After chemotherapy,the tumor shrank considerably and the above-mentioned vessels were still encased by the tumor.After surgery,the clearance of the tumor around the vessels was achieved (Figure 1).

    Figure1 Abdominal enhanced computed tomography images.

    Preoperative biopsy pathological diagnosis

    The preoperative biopsy pathological diagnosis from the left cervical lymph nodes,combined with the pathological morphology and immune phenotype,was consistent with an undifferentiated NB metastasis.The immunohistochemical results were CD-56 (+),CD-ROM9 (+,spotty),nuclear CgA (+),CKpan (-),HMB-45 (-),Ki-67 (+,>95%),LCA (-),NSE (+,focal and weak),S-100 (-),and Syn (+).

    FINAL DIAGNOSIS

    The preoperative diagnosis was NB.

    TREATMENT

    Anesthesia and position

    Tracheal intubation was performed under general anesthesia,followed by urinary catheterization.The catheterization of the right internal jugular vein and blood pressure monitoring of the right radial artery were performed routinely.The left lateral position at an angle of 45o was used.Stretch socks were worn on the lower extremities to prevent thrombosis.The robot was put on the patient’s back,the first assistant was located on the ventral side of the patient,and the instrument nurse was close to the patient’s feet.

    Trocar location

    The five-port technique was used (Figure 2).Starting from the middle point between the navel and the anterior superior iliac spine to the left lower abdomen,the pneumoperitoneum and observation hole (10 mm) were established using the Hasson technique.Operation arm #1 was located between the left anterior axillary line,the navel,and the costal margin (8 mm); operation arm #2 was located at the intersection of the right anterior axillary line and Pfannenstiel line (8 mm); one auxiliary hole was located between arm #2 (on the Pfannenstiel line) and the observation hole (12 mm);and another auxiliary hole (5 mm) (initially taken as arm 3,changing into auxiliary hole because of the narrow space leading to collision of the robotic arms) was located slightly below the left side of the xiphoid.

    Surgical procedure

    Along the right line of Toldt and the hepatic flexure of the transverse colon,the colon was turned to the left and below with a hook electrode.Through Kocher's incision,the duodenum and the pancreatic head were turned to the left to expose the inferior vena cava and the abdominal aorta.The vein was separated along the right external iliac,and the inferior vena cava was then lifted to expose the right renal vein from the bottom to the top.The tumor was transected horizontally below the renal vein and was first cut into pieces and then resected.The right renal artery and the left renal vein were also exposed,and the retrohepatic inferior vena cava was isolated.The tumor was resected along the surface of the psoas muscle,the back of the inferior vena cava,and the right side of the abdominal aorta.Finally,the lymph node metastases in front of the abdominal aorta and left renal vein were completely removed.The specimens were loaded into a disposable specimen retrieval bag and removed from the enlarged auxiliary hole.T-tube drainage was placed and brought out through a hole in the right lower quadrant of the abdomen.Each puncture hole was sutured using a 3-0 absorbable suture.

    Postoperative management

    Conventional administrations of anti-inflammatory medications,fluid replacement,gastrointestinal decompression,acid suppression,and enzymatic inhibition were performed.The abdominal drainage volume and amylase level were monitored.The gastric tube was extracted on the third day after surgery,and the patient was placed on a liquid diet.After eating a normal diet,the abdominal drainage tube was removed when no lymphatic leakage or exudate was observed,and the patient was discharged(Figure 3).

    OUTCOME AND FOLLOW-UP

    Intraoperative status

    The operative time was 389 min,the time of pneumoperitoneum was 360 min,and the intraoperative blood loss was approximately 200 mL.

    Postoperative status

    Immediately after surgery,the blood amylase level was 1426.3 U/L (normal range,0-150),the blood lipase level was 54.6 U/L (normal range,23-300),the blood alanine aminotransferase level was 197.6 U/L (normal range,0-40),and the blood aspartate aminotransferase level was 302.7 U/L (normal range,0-40).The gastric tube was extracted on the third day after surgery,and no abdominal discomfort was found after drinking water.A liquid diet was administered to the patient on the fourth day.The blood amylase level was 64.3 U/L (normal range,0-150),the blood lipase level was 240.6 U/L (normal range,23-300),the blood alanine aminotransferase level was 73.7 U/L (normal range,0-40),and the blood aspartate aminotransferase level was 49.1 U/L (normal range,0-40) on the fourth day.The patient was given pediatric food on the seventh day.The fluid in the retroperitoneal drainage tube gradually decreased; therefore,on the tenth day,the retroperitoneal drainage tube was removed,and the patient was discharged.The patient continued to receive chemotherapy after discharge.A follow-up visit was performed 2 months later.Contrast-enhanced computed tomography showed that no tumor recurrence was observed,and no effusion was found in the surgical area.

    Postoperative pathological examination

    On June 29,2018,the pathological (conventional) examination results for the right adrenal gland and retroperitoneum were obtained.Degenerated small-round cells,ganglion cells with foam cell aggregation,and hemosiderosis were scattered in the adrenal tissue and hyperplastic fibrous tissue.Locally degenerated and necrotic nodules with a large amount of foam cell aggregation and scattered calcification were found,which is consistent with postoperative changes in NB.Immunohistochemistry results were:CD56 (+),CD99 (-),NSE (+),Ki-67 (+,2%),Syn (+),CgA (-),NF (+),S-100(+) (Tumor metastasis in the left abdominal aorta).Necrosis and calcification of small lesions in fibrous connective tissues were present,but no tumor cells were found(Figure 4).

    Figure2 Trocar locations.

    DISCUSSION

    NB is the most common extracranial solid tumor in children,with an incidence of approximately 1/10000.It is also one of the most challenging operations in pediatric surgery.Traditional open surgery has disadvantages,such as the creation of a large incision,difficulty achieving deep exposure,severe trauma,and a long recovery period.Since the first report of laparoscopic adrenalectomy[20],laparoscopic adrenalectomy has been frequently reported[21-23].The application of laparoscopy in NB resection is very extensively reported in the literature; however,if the NB is closely associated with important blood vessels,the use of a laparoscope in NB resection is still challenging and has limitations.Robotic surgery is a minimally invasive surgery with greater convenience and effectiveness[24].Robot-assisted laparoscopic resection of retroperitoneal NB is rarely reported[1].

    The resection of the primary foci of stage IV NB is still a controversial issue,with some studies suggesting that it is only superior to a simple biopsy,and the prognosis is more dependent on biological characteristics rather than the number of resected primary foci[25,26].However,most researchers still suggest the resection of over 95% of the tumor foci[27,28].The primary foci of stage IV NB are often large and envelope important blood vessels,and different five-year survival rates after complete primary tumor resection (26%,30%,52%,and 65%) have been reported[29-31].To achieve a good prognosis,the resection of 95% of the tumor tissue is the goal of tumor surgeons.However,Kiely and Sultan reported that this goal can only be achieved in 89% and 58% of patients,respectively.

    La Quagliaet al[32]reported the effect of aggressive surgical resection of the tumor on the prognosis.For children with a diagnosis of stage IV NB,complete removal of the tumor is unachievable.Delayed surgery or a second surgery can improve local tumor shrinkage and the metastasis disappearance rate after preoperative chemotherapy and prolong survival.However,the study by Castelet al[26]denied the therapeutic effect of surgical resection of stage IV NB and suggested that age,N-myc gene amplification,and distant metastasis have a much greater influence on the prognosis of stage IV NB than complete resection.Therefore,the treatment of stage IV NB should be a combination of surgery,radiotherapy,chemotherapy,and other treatments.Preoperative chemotherapy is necessary to remove the NB that envelopes important peritoneal blood vessels.Through chemotherapy,tumors can shrink significantly and harden,and the blood supply and other risk factors can decrease,making the resection of unresectable tumors possible[33,34].

    Separation is one of the techniques used to protect important blood vessels.We started from the relatively normal right common iliac vein,separated the inferior vena cava from bottom to top,ligated the right gonadal vein,and separated the right renal vein and left renal vein.Horizontal tumor transection was performed below the right renal vein to facilitate the exposure of the right renal artery and the right superior mesenteric artery.The inferior vena cava was lifted again,and the tumor above the right renal vein and on the right side of the abdominal aorta was resected.During the resection,the right adrenal gland covered the top of the tumor in the form of a sheet,and there was no significant thickened right middle adrenal vein.It is considered that the tumor originated from the retroperitoneal sympathetic nerve chain instead of the right adrenal gland.Finally,metastatic tumors in front of the left kidney were excised.During the separation process,we found that the stability of the hook electrode was better than that of electric scissors,and the hemostatic effect of the bipolar electrosurgical knife was good.

    Figure3 lncision healing at 2 mo after five-port laparoscopic surgery.

    Piecemeal resection is a necessary technique[35].Because the tumor envelopes the blood vessels,the vessels cannot be preserved without opening the tumor; thus,the tumor cannot be removed wholly.During NB resection in the advanced stages,en blocresection cannot be achieved; therefore,piecemeal resection is necessary to improve the prognosis.

    Maximization of the operating space should be considered.Children are typically short,and the abdominal space is small.The appropriate Trocar positions are below and to the left of the umbilicus.After placing the Trocar and the lens under the umbilicus,two auxiliary holes (left lower abdomen and left lateral xiphoid) should be arranged,since the operation is mainly performed in the right upper abdomen and behind the inferior vena cava.Arms #1 and #2 were arranged on the left side of the abdomen and the right lower abdomen,respectively,which can operate on the lesions on the right side and upper abdomen.During the operation,a cold lens was placed in the left lower abdomen,expanding the operating space.The operation was completed using the five-port approach,and no instruments collided with each other.

    Robot assistance is the key to the skeletonization of blood vessels.Conventional laparoscopic surgery is difficult and cannot achieve the resection of complex tumors.During the operation,the inferior vena cava,the bilateral renal veins,and the right renal artery are skeletonized; therefore,surgery is difficult,and the risk is high.Robots can provide a three-dimensional view with 10 × magnification.Shaking can be eliminated,and hand actions can be simulated.The robots can complete clamping,suturing,knotting,and other operations and achieve results similar to those of open surgery.Robotic surgery can preserve the aesthetic characteristics of the laparoscopic surgical incision.We placed arm #2 and auxiliary hole #1 on the Pfannenstiel line,and the tumor specimens were obtained from this line,which improves the postoperative appearance.No common complications,such as postoperative diarrhea[36],lymphatic fistula,or intestinal obstruction,were found.However,due to the long operative time,redness and swelling of the left waist skin occurred but completely disappeared after one week.Because of the isolation of the pancreas and liver,the amylase and transaminase levels also showed a transient increase but soon returned to normal.Robotic-assisted surgery not only maintains the advantages of minimally invasive surgery,such as small wounds,good aesthetics,and short operative time,hospitalization stay,and postoperative recovery time,but also addresses the limitations of open surgery and laparoscopic technology.

    This case is the first pediatric robot-assisted laparoscopic resection of stage IV NB(according to the International Neuroblastoma Staging System criteria) at our hospital,and no serious complications during or after surgery were found.The surgical experience of this case showed that robot-assisted resection of retroperitoneal NB is feasible and can be a new approach for the treatment of advanced NB.

    Figure4 Pathological images.

    色噜噜av男人的天堂激情| 色播亚洲综合网| 久久性视频一级片| 直男gayav资源| 国产精品人妻久久久久久| 国产视频一区二区在线看| 人人妻人人澡欧美一区二区| 国产蜜桃级精品一区二区三区| 深爱激情五月婷婷| 精品熟女少妇八av免费久了| 欧美最黄视频在线播放免费| 亚洲经典国产精华液单 | 日本一二三区视频观看| 精品99又大又爽又粗少妇毛片 | 日本免费一区二区三区高清不卡| 国产欧美日韩精品亚洲av| 丝袜美腿在线中文| 精品久久久久久成人av| 看十八女毛片水多多多| 国产高清激情床上av| 亚洲av一区综合| 狂野欧美白嫩少妇大欣赏| 久久久精品大字幕| 亚洲 欧美 日韩 在线 免费| 丰满的人妻完整版| av视频在线观看入口| 99久久精品国产亚洲精品| 国产精品电影一区二区三区| 久久久久久九九精品二区国产| 国产精品,欧美在线| 日日干狠狠操夜夜爽| 在线看三级毛片| 国产在线男女| 嫩草影视91久久| 波多野结衣高清作品| 亚洲精品久久国产高清桃花| 国产综合懂色| 亚洲精品在线美女| 国产av不卡久久| 嫁个100分男人电影在线观看| 亚洲久久久久久中文字幕| 两性午夜刺激爽爽歪歪视频在线观看| 人人妻,人人澡人人爽秒播| 国产黄a三级三级三级人| 毛片女人毛片| 啦啦啦韩国在线观看视频| 成人特级黄色片久久久久久久| 久久亚洲精品不卡| 久久亚洲真实| 又黄又爽又刺激的免费视频.| 波野结衣二区三区在线| 色吧在线观看| 日韩亚洲欧美综合| 日日夜夜操网爽| 999久久久精品免费观看国产| 久久婷婷人人爽人人干人人爱| 两个人视频免费观看高清| 亚洲一区高清亚洲精品| 国产精品国产高清国产av| 无遮挡黄片免费观看| 久久久精品欧美日韩精品| 51国产日韩欧美| 欧美最黄视频在线播放免费| 老熟妇仑乱视频hdxx| 日本精品一区二区三区蜜桃| 免费观看的影片在线观看| 尤物成人国产欧美一区二区三区| 在线观看66精品国产| 一区福利在线观看| 午夜老司机福利剧场| 欧洲精品卡2卡3卡4卡5卡区| 99久久九九国产精品国产免费| 久久国产乱子免费精品| 一个人观看的视频www高清免费观看| 蜜桃亚洲精品一区二区三区| 婷婷精品国产亚洲av| 久久精品久久久久久噜噜老黄 | 91麻豆av在线| 婷婷精品国产亚洲av| 99久久精品热视频| 亚洲最大成人手机在线| 亚洲av中文字字幕乱码综合| 免费看a级黄色片| 十八禁网站免费在线| 久久久久久大精品| 我要看日韩黄色一级片| 超碰av人人做人人爽久久| 一个人免费在线观看电影| 国产精品久久久久久人妻精品电影| 少妇裸体淫交视频免费看高清| 有码 亚洲区| 久久久精品欧美日韩精品| 九九热线精品视视频播放| 亚洲性夜色夜夜综合| 午夜亚洲福利在线播放| 一个人观看的视频www高清免费观看| 久久久久九九精品影院| 亚洲欧美日韩高清专用| 18禁黄网站禁片午夜丰满| 校园春色视频在线观看| av福利片在线观看| 国产私拍福利视频在线观看| 在现免费观看毛片| 国产在线男女| 少妇丰满av| 51午夜福利影视在线观看| 国产精品伦人一区二区| 怎么达到女性高潮| 成人精品一区二区免费| 欧美成人a在线观看| 最后的刺客免费高清国语| 人妻久久中文字幕网| 久久精品国产亚洲av涩爱 | 女人十人毛片免费观看3o分钟| 亚洲av免费高清在线观看| 老女人水多毛片| 亚洲 欧美 日韩 在线 免费| 97超视频在线观看视频| 一本久久中文字幕| 国产又黄又爽又无遮挡在线| 在线观看免费视频日本深夜| 中文字幕人成人乱码亚洲影| 国产一区二区激情短视频| 久久精品影院6| 99在线人妻在线中文字幕| 亚洲最大成人手机在线| 国产色婷婷99| 国产一级毛片七仙女欲春2| 人人妻人人澡欧美一区二区| 久久婷婷人人爽人人干人人爱| 五月玫瑰六月丁香| 欧美日韩中文字幕国产精品一区二区三区| 亚洲av电影在线进入| 夜夜爽天天搞| 一边摸一边抽搐一进一小说| 久久久国产成人免费| 欧美中文日本在线观看视频| 高清在线国产一区| 国产av麻豆久久久久久久| 国产精品国产高清国产av| 亚洲欧美日韩无卡精品| 国产精品精品国产色婷婷| 国产成人欧美在线观看| 麻豆成人av在线观看| 天堂√8在线中文| 99久久精品国产亚洲精品| 亚洲国产精品合色在线| 国产精品久久久久久精品电影| 亚洲五月婷婷丁香| 亚洲av中文字字幕乱码综合| 草草在线视频免费看| 午夜精品在线福利| 国产伦一二天堂av在线观看| 色吧在线观看| 麻豆av噜噜一区二区三区| 黄色配什么色好看| 国产精品一区二区三区四区久久| 免费看日本二区| 一个人看的www免费观看视频| 国产精品,欧美在线| 一进一出抽搐动态| 激情在线观看视频在线高清| 久久精品影院6| 99热这里只有是精品在线观看 | 久久性视频一级片| 两性午夜刺激爽爽歪歪视频在线观看| 天堂动漫精品| 99热这里只有精品一区| 精品国产亚洲在线| 欧美日韩乱码在线| 亚洲三级黄色毛片| 久久精品夜夜夜夜夜久久蜜豆| 一本久久中文字幕| 国产探花极品一区二区| 欧美精品国产亚洲| 亚洲男人的天堂狠狠| 亚洲电影在线观看av| 久久久久久久午夜电影| 中出人妻视频一区二区| 悠悠久久av| 99国产综合亚洲精品| 欧美另类亚洲清纯唯美| 国内少妇人妻偷人精品xxx网站| 18禁在线播放成人免费| 国产综合懂色| 亚洲精品成人久久久久久| 男插女下体视频免费在线播放| 亚洲中文日韩欧美视频| 丰满的人妻完整版| 精品无人区乱码1区二区| 白带黄色成豆腐渣| 亚洲无线在线观看| 尤物成人国产欧美一区二区三区| 国产午夜精品久久久久久一区二区三区 | 熟妇人妻久久中文字幕3abv| 久久精品影院6| 国产单亲对白刺激| 人妻夜夜爽99麻豆av| 极品教师在线免费播放| 国产视频内射| a级一级毛片免费在线观看| 亚洲国产精品合色在线| 国产一级毛片七仙女欲春2| 一级a爱片免费观看的视频| 天堂动漫精品| 天美传媒精品一区二区| 亚洲最大成人手机在线| 亚洲久久久久久中文字幕| 久久久久久久久中文| 老熟妇仑乱视频hdxx| 日韩欧美三级三区| 亚洲黑人精品在线| 国产亚洲av嫩草精品影院| 国产三级在线视频| 久久久成人免费电影| 乱人视频在线观看| 国产精品嫩草影院av在线观看 | 欧美3d第一页| 三级毛片av免费| 国产在线精品亚洲第一网站| 欧美最新免费一区二区三区 | 十八禁人妻一区二区| 亚洲国产精品久久男人天堂| 国产精品一区二区三区四区免费观看 | www.www免费av| 久久精品国产亚洲av天美| 欧美激情久久久久久爽电影| 日韩中字成人| 男女视频在线观看网站免费| 免费看日本二区| 夜夜看夜夜爽夜夜摸| 最近视频中文字幕2019在线8| 国产在视频线在精品| 日本五十路高清| 国模一区二区三区四区视频| 757午夜福利合集在线观看| 男女床上黄色一级片免费看| 蜜桃亚洲精品一区二区三区| 欧美又色又爽又黄视频| 男女下面进入的视频免费午夜| 男人和女人高潮做爰伦理| 亚洲,欧美,日韩| 欧美午夜高清在线| 极品教师在线视频| 人人妻人人澡欧美一区二区| 成年人黄色毛片网站| 国产精品99久久久久久久久| 精品午夜福利在线看| 欧美中文日本在线观看视频| 神马国产精品三级电影在线观看| 成人午夜高清在线视频| 免费av观看视频| 国产精品久久久久久精品电影| 国产视频内射| 国产三级中文精品| 俺也久久电影网| 亚洲无线观看免费| 久久久久久大精品| 欧美潮喷喷水| 五月玫瑰六月丁香| 亚洲人成网站在线播| 91久久精品电影网| 亚洲精品影视一区二区三区av| 成人精品一区二区免费| 国产精品免费一区二区三区在线| 国产亚洲欧美98| 我的老师免费观看完整版| 夜夜爽天天搞| 757午夜福利合集在线观看| 国产一区二区亚洲精品在线观看| 男女那种视频在线观看| 丰满的人妻完整版| 特大巨黑吊av在线直播| 国产午夜精品久久久久久一区二区三区 | 不卡一级毛片| 国模一区二区三区四区视频| 久久久久久久久久成人| 欧美性猛交╳xxx乱大交人| 午夜精品一区二区三区免费看| 国内揄拍国产精品人妻在线| 亚洲av不卡在线观看| 亚洲av成人不卡在线观看播放网| 真人一进一出gif抽搐免费| 国产精品98久久久久久宅男小说| 欧美性感艳星| 赤兔流量卡办理| 88av欧美| 日本在线视频免费播放| 男女下面进入的视频免费午夜| 久久久久性生活片| 亚洲中文字幕一区二区三区有码在线看| 日日干狠狠操夜夜爽| 看黄色毛片网站| 亚洲激情在线av| 首页视频小说图片口味搜索| 国产精品久久久久久亚洲av鲁大| 久久久久国内视频| 一级黄色大片毛片| 中亚洲国语对白在线视频| 内射极品少妇av片p| a级毛片免费高清观看在线播放| 亚洲在线自拍视频| 亚州av有码| 亚洲av电影不卡..在线观看| 少妇人妻一区二区三区视频| 性欧美人与动物交配| 久久久久久九九精品二区国产| 午夜免费激情av| 国产精品乱码一区二三区的特点| 一个人免费在线观看电影| 在线国产一区二区在线| 女生性感内裤真人,穿戴方法视频| 老师上课跳d突然被开到最大视频 久久午夜综合久久蜜桃 | 国产美女午夜福利| 成人毛片a级毛片在线播放| 男人的好看免费观看在线视频| 网址你懂的国产日韩在线| 一夜夜www| 少妇的逼水好多| 亚洲精品色激情综合| 亚洲男人的天堂狠狠| 国产真实伦视频高清在线观看 | 在线播放无遮挡| 五月玫瑰六月丁香| 国内精品久久久久精免费| 国产精品久久久久久精品电影| 欧美极品一区二区三区四区| 少妇丰满av| 男人狂女人下面高潮的视频| 精品人妻1区二区| bbb黄色大片| 午夜福利在线观看免费完整高清在 | 精品久久久久久成人av| 网址你懂的国产日韩在线| 亚洲欧美日韩高清在线视频| 悠悠久久av| 久久久精品欧美日韩精品| 高清在线国产一区| 久久久久久九九精品二区国产| 久久久久久久精品吃奶| 免费人成在线观看视频色| eeuss影院久久| 嫁个100分男人电影在线观看| 成人一区二区视频在线观看| 亚洲成人久久性| 搡老妇女老女人老熟妇| 99久国产av精品| 午夜两性在线视频| АⅤ资源中文在线天堂| 欧美3d第一页| h日本视频在线播放| 国产精品一区二区三区四区久久| 最新在线观看一区二区三区| 欧美最新免费一区二区三区 | 久久天躁狠狠躁夜夜2o2o| 国产成人a区在线观看| 国内少妇人妻偷人精品xxx网站| 女人十人毛片免费观看3o分钟| 亚洲avbb在线观看| 精品一区二区三区人妻视频| 国产伦人伦偷精品视频| 欧美最黄视频在线播放免费| 精品国产三级普通话版| 非洲黑人性xxxx精品又粗又长| 国产亚洲精品久久久久久毛片| 亚洲无线在线观看| 精品久久久久久成人av| 大型黄色视频在线免费观看| 国产免费男女视频| 国产精品国产高清国产av| 欧美又色又爽又黄视频| 少妇高潮的动态图| 少妇被粗大猛烈的视频| 午夜福利在线观看吧| 男女那种视频在线观看| 欧美又色又爽又黄视频| 欧美性感艳星| 国产高清三级在线| 日韩成人在线观看一区二区三区| 男人的好看免费观看在线视频| 国产伦一二天堂av在线观看| 亚洲激情在线av| 免费在线观看成人毛片| 日本成人三级电影网站| 偷拍熟女少妇极品色| 夜夜躁狠狠躁天天躁| 久久精品国产自在天天线| 麻豆国产av国片精品| 欧美绝顶高潮抽搐喷水| 国产三级黄色录像| 最近在线观看免费完整版| 小说图片视频综合网站| 一本一本综合久久| 国产乱人视频| 麻豆av噜噜一区二区三区| 精品久久久久久成人av| 久久精品国产清高在天天线| 尤物成人国产欧美一区二区三区| 美女高潮喷水抽搐中文字幕| 国产欧美日韩精品一区二区| 舔av片在线| 国产午夜精品论理片| 天美传媒精品一区二区| 国产乱人伦免费视频| 老鸭窝网址在线观看| 黄色一级大片看看| 中亚洲国语对白在线视频| 国产精品亚洲一级av第二区| 免费观看的影片在线观看| 精品国产亚洲在线| 日韩 亚洲 欧美在线| 91字幕亚洲| 午夜激情福利司机影院| 久久人人精品亚洲av| 久久草成人影院| 精华霜和精华液先用哪个| 99久国产av精品| avwww免费| 日韩欧美在线二视频| 香蕉av资源在线| 淫妇啪啪啪对白视频| 亚洲精品色激情综合| 高潮久久久久久久久久久不卡| 麻豆国产97在线/欧美| 天堂av国产一区二区熟女人妻| 国产一区二区亚洲精品在线观看| 成人永久免费在线观看视频| 性插视频无遮挡在线免费观看| 99视频精品全部免费 在线| 亚洲最大成人手机在线| 97碰自拍视频| 极品教师在线视频| 久久久久久久久大av| 天堂网av新在线| 欧美一区二区国产精品久久精品| 久久久久免费精品人妻一区二区| 免费人成视频x8x8入口观看| 亚洲人成网站在线播放欧美日韩| 国产欧美日韩一区二区精品| 久久欧美精品欧美久久欧美| 老司机福利观看| 成人特级av手机在线观看| 色噜噜av男人的天堂激情| 久久久色成人| 黄色日韩在线| 噜噜噜噜噜久久久久久91| 国产高清三级在线| eeuss影院久久| 亚洲人成电影免费在线| 国产精品一区二区三区四区免费观看 | 国产成人影院久久av| 久久久久久久久久成人| 亚洲av成人av| 色av中文字幕| 悠悠久久av| 高清毛片免费观看视频网站| 人妻制服诱惑在线中文字幕| 欧美性猛交╳xxx乱大交人| 国产成+人综合+亚洲专区| 成人午夜高清在线视频| 亚洲 欧美 日韩 在线 免费| 美女 人体艺术 gogo| 一级a爱片免费观看的视频| 久久伊人香网站| 亚洲国产欧洲综合997久久,| 午夜日韩欧美国产| 两个人视频免费观看高清| 国产视频一区二区在线看| 久9热在线精品视频| 男人舔奶头视频| 91麻豆av在线| 久久久久久久久久黄片| 国产在线男女| 亚洲aⅴ乱码一区二区在线播放| 麻豆成人av在线观看| 成年人黄色毛片网站| 亚洲 国产 在线| 极品教师在线视频| 深夜精品福利| 成人精品一区二区免费| 丝袜美腿在线中文| 国内精品美女久久久久久| 日本撒尿小便嘘嘘汇集6| 精品久久久久久久久亚洲 | 女同久久另类99精品国产91| 一进一出抽搐动态| 在线观看一区二区三区| 亚洲三级黄色毛片| 男女之事视频高清在线观看| 久久精品91蜜桃| 免费在线观看亚洲国产| 黄色女人牲交| 赤兔流量卡办理| 女人十人毛片免费观看3o分钟| 日本黄色视频三级网站网址| 国产日本99.免费观看| 国产高清激情床上av| 国产探花在线观看一区二区| 国内毛片毛片毛片毛片毛片| 一级黄色大片毛片| 少妇人妻精品综合一区二区 | 美女高潮的动态| 国产精品久久久久久精品电影| 丁香六月欧美| а√天堂www在线а√下载| 亚洲精品在线美女| 国产精品亚洲av一区麻豆| 男女做爰动态图高潮gif福利片| 国产探花在线观看一区二区| 亚洲七黄色美女视频| 九九在线视频观看精品| 国产成人av教育| 婷婷色综合大香蕉| 亚洲三级黄色毛片| 国产高清有码在线观看视频| 人妻夜夜爽99麻豆av| 亚洲精品456在线播放app | 日韩免费av在线播放| 日本 av在线| 国产成人aa在线观看| 午夜两性在线视频| 午夜老司机福利剧场| 婷婷精品国产亚洲av| 欧美日韩中文字幕国产精品一区二区三区| 一夜夜www| 欧美高清成人免费视频www| 久久久久久久午夜电影| 午夜视频国产福利| 精品国产三级普通话版| 九色成人免费人妻av| 男女那种视频在线观看| 国产男靠女视频免费网站| 成人av在线播放网站| 国产一级毛片七仙女欲春2| 久久天躁狠狠躁夜夜2o2o| 国内精品一区二区在线观看| av在线天堂中文字幕| 99精品在免费线老司机午夜| 精品乱码久久久久久99久播| 尤物成人国产欧美一区二区三区| 亚洲真实伦在线观看| 99精品久久久久人妻精品| 日本黄大片高清| 久99久视频精品免费| 日本免费一区二区三区高清不卡| 亚洲av免费高清在线观看| 国产精品综合久久久久久久免费| 精品人妻熟女av久视频| 波多野结衣高清无吗| 日本黄色片子视频| 久久国产乱子免费精品| 欧美日韩亚洲国产一区二区在线观看| 久久亚洲精品不卡| 老女人水多毛片| 久久人人爽人人爽人人片va | 99久久九九国产精品国产免费| 亚洲欧美清纯卡通| 亚洲精品日韩av片在线观看| 亚洲在线自拍视频| 国产高清有码在线观看视频| ponron亚洲| 欧美国产日韩亚洲一区| 黄色视频,在线免费观看| 动漫黄色视频在线观看| 91麻豆av在线| 久久久久久国产a免费观看| 白带黄色成豆腐渣| 很黄的视频免费| 国产欧美日韩一区二区三| 亚洲成av人片在线播放无| 男插女下体视频免费在线播放| 日韩欧美精品v在线| 中文字幕人妻熟人妻熟丝袜美| 美女xxoo啪啪120秒动态图 | 午夜激情欧美在线| 亚洲自拍偷在线| 中文字幕免费在线视频6| 老熟妇乱子伦视频在线观看| 欧美xxxx性猛交bbbb| 国产私拍福利视频在线观看| 内射极品少妇av片p| 欧美日韩福利视频一区二区| 国产主播在线观看一区二区| 人人妻人人看人人澡| 久久久久国内视频| 亚洲精品日韩av片在线观看| 日日摸夜夜添夜夜添小说| 一边摸一边抽搐一进一小说| 波多野结衣高清无吗| 99热这里只有是精品50| 日韩av在线大香蕉| 欧美+亚洲+日韩+国产| 老女人水多毛片| 两个人视频免费观看高清| 欧美+亚洲+日韩+国产| 观看免费一级毛片| 一个人免费在线观看电影| 国内少妇人妻偷人精品xxx网站| 尤物成人国产欧美一区二区三区| 少妇裸体淫交视频免费看高清| 国产高清视频在线播放一区| 精品久久久久久久久久久久久| 一个人免费在线观看电影| 在线观看av片永久免费下载| 老女人水多毛片| 欧美激情在线99| av中文乱码字幕在线| 国产探花在线观看一区二区| 18美女黄网站色大片免费观看| 精品人妻视频免费看| 麻豆一二三区av精品| 青草久久国产| 草草在线视频免费看| 国产免费男女视频| 三级毛片av免费|