原发性腹膜后肿瘤69例诊治体会  

Experience on Diagnosis and Treatment of 69 Cases of Primary Retroperitoneal Tumors

作　　者：于世良[1] 王建[1] 胡兴明[1] 刘先武[1] 

机构地区：[1]徐州医学院第二附属医院普外科,江苏徐州221006

出　　处：《中国普外基础与临床杂志》2010年第8期832-836,共5页Chinese Journal of Bases and Clinics In General Surgery

摘　　要：目的总结原发性腹膜后肿瘤(PRT)的诊治体会。方法回顾性分析我科1998年6月至2008年6月间收治的69例PRT患者的临床资料。结果 PRT以腹痛、腹胀和腹部包块为主要症状,超声、CT、MRI等影像学检查可有效地检出。病理组织学分类主要分为软组织肿瘤、生殖细胞肿瘤、淋巴造血系统肿瘤和其他少见的肿瘤。69例患者中行肿瘤完全切除术42例,联合脏器切除术10例,肿瘤部分切除术11例,肿瘤不能切除仅行活检者6例。术中出现血管、脏器损伤10例,行修补或血管缝扎与联合脏器切除术。术后发生并发症8例,均经保守治疗后治愈。术后发生急性应激性溃疡出血合并多脏器功能衰竭死亡1例。肿瘤完整切除者术后1、3和5年生存率分别为71%、64%和46%。11例肿瘤部分切除术患者中8例于1年内死亡,3例于3年内死亡。恶性肿瘤不能切除仅行活检者均在术后1年内死亡。结论综合运用影像学检查能明确诊断;尽可能手术切除肿瘤,以提高患者生存率。Objective To summarize the experience in diagnosis and treatment of primary retroperitoneal tumor （PRT）. Methods Clinical data of 69 patients with PRT from June 1998 to June 2008 were analyzed retrospectively. Results Bellyache,abdominal distention,and abdominal mass were common symptoms in the patients with PRT. Ultrasound,CT,and MRI examination were effective. The major histopathological classification was soft tissue tumor,germinoma,lymphatic hematopoietic system tumors,and other rare tumors. Complete resection of tumors was performed in 42 cases,combined organs resection in 10 cases,partial resection of tumors in 11 cases,and only biopsy in 6 cases. There were 10 cases of intraoperative vessel and organ injury,which were treated by repair or vessels suturing and combined organ resection. Postoperative complications occurred in 8 cases,which were cured by conservative treatment. One patient died of hemorrhage acute stress ulcer combined multiple organ failure. The survival rates of 1,3,and 5 years in patients underwent complete resection of tumors were 71%,64%,and 46%,respectively. Of 11 patients underwent partial resection of tumors,8 cases died within one year,and 3 cases died within 3 years after operation. All malignant tumor patients treated by biopsy died within one year after operation. Conclusion Synthetically using imaging examination may diagnose definitely,and to resect tumors as much as possible will improve patients＇ survival.

关 键 词：原发性腹膜后肿瘤 诊断 治疗 外科手术 预后 复发 

分 类 号：R735.4[医药卫生—肿瘤]