腹膜后肿瘤联合血管切除重建29例临床应用  

Clinical application of combined vascular reconstruction in the treatment of retroperitoneal tumors report of 29 cases

作　　者：戈小虎[1] 亚力坤[1] 李雪松[1] 赛力木[1] 任昊[1] 方青波[1] 

机构地区：[1]新疆维吾尔自治区人民医院血管外科,830001

出　　处：《中华疝和腹壁外科杂志（电子版）》2011年第1期25-28,共4页Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition)

摘　　要：目的探讨联合血管切除重建治疗腹膜后肿瘤的必要性和合理性。方法回顾性分析自2000年1月至2010年2月收治的29例侵及血管的腹膜后肿瘤病例,其中男20例,女9例,年龄10～76岁,平均年龄52岁。检查结果显示肿瘤侵润、包绕重要血管19例,肿瘤与重要血管关系密切、推移10例。所有病例均行肿块完整切除联合血管重建。结果本组无围手术期死亡,获随访24例。随访时间8～89个月,平均随访5.2年。2例下腔静脉及4例髂静脉分别于手术后3～9个月发生血栓,未出现明显肢体肿胀。无人工血管感染病例,1年生存率为100%,1～5年死亡12例,存活5年以上10例,其中3例肿瘤复发再次手术。其余病例尚在随访中。结论对于腹膜后肿瘤侵犯周围血管,术中难以分离的病例,联合血管切除重建增加了切除率,提高了存活率。Objective To discuss the necessity and rationality of combined vascular reconstruction in the treatment of retroperitoneal tumors.Methods 29 patients who suffered form retroperitoneal tumors involving major blood vessels,undergoing operation in our department from January 2000 to February 2010,were analyzed retrospectively,there were 20 men and 9 women with an age ranging from 10 to 76（mean =52）,19 cases with retroperitoneal tumors infiltrating and surrounding major blood,10 cases nearby and lapsing the major blood.All cases were treated by resection of the tumor enbloc and the major blood vessel involved followed by vascular reconstruction.Results There was no operative death,24 patients were followed up from 8 to 89 months（mean 5.2 years）.2 inferior caval veins and 4 vena iliacas occ-urred thrombus after operation 3 to 9 months,but in those cases,there were no swelling of limb.No vascular prosthesis infection.One year survival rate was 100%,12 cases died after 1 to 5 years,10 case survived beyond 5 years,containing 3 cases with tumor palindromia accepted re-operations,another survivals are followed up until now.Conclusions With the cases of retroperitoneal tumor involving major blood vessels and with high difficultly in dissecting,tumor can be removed more thoroughly followed by vascular reconstruction.The risk of local tumor residual can thus be minimized and better survival achieved.

关 键 词：腹膜后肿瘤 外科手术 切除 血管重建 

分 类 号：R735.4[医药卫生—肿瘤]