经后路一期切除累及腹部脏器的腰段巨大原发性哑铃状肿瘤  

Resecting large primary dumbbell tumor tangled with abdominal organs in lumbar region through singlestage posterior approach

作　　者：郑阳[1] 李晶[1] 

机构地区：[1]中南大学湘雅二医院脊柱外科,湖南长沙410011

出　　处：《医学研究与教育》2014年第1期46-50,共5页Medical Research and Education

摘　　要：目的探讨单独经后路切除累及腹部重要脏器的原发性脊柱巨大的哑铃状肿瘤的可行性、安全性及效果。方法回顾分析18例患腰段脊柱原发性巨大哑铃型肿瘤患者的临床资料、手术记录、病理检查结果及随访资料。早期8例行前后联合入路手术。后期的10例患者采用单独后路手术。结果早期8例前后联合入路手术时间平均5 h、出血量平均800 mL。7例症状消失,未见肿瘤复发;1例术后5个月死于脑转移。后期10例经单独后路手术用时平均3 h、出血平均450 mL。10例随访,症状消失,未发现复发。结论累及腹部脏器的腰段原发大型哑铃状肿瘤可以通过单纯后路一期手术安全地切除。对比前后路联合手术,单纯后路手术是一种更加简单、微创、有效的手术方式。Objective To evaluate the feasibility, safety and effect of resection large spinal-retroperitoneal dumbbell tumor tangled with vital abdominal organs through independent posterior approach. Methods 18 patients＆#39; clinical data, operation records, pathologic examination results and follow-up data were included in this retrospective analysis. In the initial 8 patients, combined surgical approaches from back and front were used. The later 10 patients were operated on using an independent improved posterior approach to remove tumor. Results In earlier 8 patients who underwent a combined surgery from posterior and antero-lateral approaches, total surgical time averaged 5 hours, the blood loss averaged 800 mL. 1 patient died of brain metastasis 5 months post-surgically. 7 cases symptoms disappeared, no tumor recurrence. In later 10 patients, only independent posterior approach was used, operative time averaged 3 hours, blood loss averaged 450 mL. All patients were not tumor recurrence and symptoms disappear. Conclusion Primary large dumbbell tumor in lumbar region which tangles with abdominal organ can be safely removed through independent posterior approach. Compared with combined posterior and anterior approaches, independent posterior approach is more simple, less traumatic, and similarly effective.

关 键 词：腰椎 巨大型哑铃状肿瘤 腹部脏器受累 肿瘤切除 前后路联合入路 单纯后路 

分 类 号：R73[医药卫生—肿瘤]