骶前肿瘤手术27例临床分析  

Clinical Analysis of Presacral Tumor(27 Cases Report)

作　　者：崔龙[1] 孟荣贵[2] 王中川[1] 陈卫[1] 陈大伟[1] 杨明[1] 杜鹏[1] 徐佶[1] 

机构地区：[1]上海交通大学医学院附属新华医院肛肠外科上海交通大学结直肠癌诊治中心,上海200092 [2]第二军医大学附属长海医院肛肠外科,上海200433

出　　处：《中国现代手术学杂志》2009年第3期180-183,共4页Chinese Journal of Modern Operative Surgery

摘　　要：目的探讨骶前肿瘤的诊断及手术治疗方法及经验。方法骶前肿瘤患者27例，21例初发，6例为复发。均行肛指检查、CT和（／或）MRI作出诊断。肿瘤直径平均6．3（2．4～10．3）cm。单纯经腹手术2例，单纯经骶手术20例，经腹经骶联合手术5例。结果切口一期愈合21例。病理类型：皮样囊肿7例，表皮样囊肿6例，畸胎瘤4例（1例恶变），平滑肌瘤3例，神经纤维瘤2例，脂肪瘤1例，感染形成脓肿3例，皮脂腺囊肿1例。所有患者均获随访，时间7～14个月。3例经骶手术复发，其中2例为皮样囊肿切除后引流不畅形成积液，再行手术切除引流治愈；1例畸胎瘤手术后复发，再行经骶切除后成功。1例感染形成的脓肿复发，经加强局部引流后愈合。结论骶前肿瘤诊断并不困难，CT等检查可指导手术方式。大多数肿瘤都可以采用经骶入路切除，手术后引流通畅是保障愈合的关键。Objective To investigate the experiences of the diagnosis methods and the surgical treatment approaches for presacral tumor. Methods Among the 27 presacral tumor patients, 21 were primary tumors and 6 were recurrent tumors. All the patients were diagnosed by rectal examination and CT/MRI. The mean tumor diameter was 6.3 （ 2.4 - 10.3 ） cm. Two cases were operated through abdominal approach, 20 through sacrocoecygeal approach and 5 through combined abdominal and sacrococcygeal route. Results The primary incision healing was seen in 21 patients. The pathological types were as follows： 7 dermoid cyst, 6 epidermoid cyst, 4 teratoma with 1 canceration, 3 leiomyoma, 2 neurofibroma, 1 lipoma, 3 abscess by infection and 1 sebaceous cyst. All patients were followed up for 7 to 14 months. Three cases through sacrococcygeal route relapsed, among which 2 were hydrops due to inadequate drainage after dermoid cyst resection and cured by re - surgical ablation and draining; the other one was a recurrent case after teratoma resection and was successfully re-operated through sacrococcygeal route. Conclusion The diagnosis of presacral tumor is not difficult. The operative methods may be judged by examinations such as CT etc. Most presaeral tumors can be resected through sacrococcygeal route and the unobstructed postoperative drainage is the key for healing.

关 键 词：骶前肿瘤 

分 类 号：R739.93[医药卫生—肿瘤]