巨大腹膜后肿瘤的外科手术策略  

Surgical strategies for huge retroperitoneal tumors： clinical experiences of 59 cases

作　　者：白韬[1] 王发伦 孙备[1] 白雪巍[1] 陈华[1] 姜洪池[1] 

机构地区：[1] 哈尔滨医科大学附属第一医院胰胆外科,哈尔滨150001 [2] 黑龙江省鹤岗市人民医院

出　　处：《腹部外科》2014年第1期11-14,共4页Journal of Abdominal Surgery

基　　金：卫生公益性行业科研专项经费资助项目（201202007）;国家自然科学基金资助项目（81170431,81372613,81370565）;高等学校博士学科点专项基金（20122307110012）

摘　　要：目的 探讨巨大腹膜后肿瘤的临床特征及其外科手术治疗的要点和难点.方法 对2006年5月至2013年5月在哈尔滨医科大学附属第一医院手术切除的59例巨大腹膜后肿瘤（肿瘤直径＆gt;10 cm）的临床资料进行回顾性分析.结果 59例巨大腹膜后肿瘤均经病理确诊,其中良性肿瘤22例,恶性肿瘤37例.48例获得随访,随访时间为5个月至7年,良性肿瘤18例,完整切除15例,其中原位复发5例;恶性肿瘤30例,完整切除26例,其中原位复发12例.二次手术3例.死亡6例,3例为完整切除原位复发,3例为姑息切除.结论 巨大腹膜后肿瘤手术难度大,风险高,术前认真评估及准备,术中稳健操作,准确判断,力求做到R0切除方能使患者长期受益.Objective To explore the clinical features and surgical essentials and difficulties of huge retroperitoneal tumors. Methods The clinical data of 59 surgical cases of huge retroperitoneal tumor （diameter）I0 cm） between May 2006 and May 2013 at First Affiliated Hospital, Harbin Med- ical University were analyzed retrospectively. Results The pathological diagnosis was all confirmed. There were benign （n = 22） and malignant （n = 37） cases. Among them, 48 cases were followed up for 5 months to 7 years. And 18 cases were benign and another 15 cases underwent complete excision. Five cases had local recurrence. Among 30 malignant cases, 26 of them had complete excision and lo- cal recurrence occurred in 12 cases. Three cases underwent secondary procedures. Among 6 mortali- ties, 3 cases had complete excision and local recurrence while another 3 with palliative excision had complete excision and local recurrence. Conclusion Huge retroperitoneal tumors carry great surgical difficulties and risks. Only thorough planning, meticulous handling and R0 excision may achieve long- term patient benefits.

关 键 词：腹膜后肿瘤 外科手术 诊断 方法 

分 类 号：R735.4[医药卫生—肿瘤]