经骶尾部入路治疗骶前发育性囊肿临床疗效(附19例报告)  

Experience of treating developmental cysts by sacral anterior sacral therapy approach

作　　者：温圣荣[1] 余智涛[1] 王悦辉[1] 李学化[1] 侯辉[1] 

机构地区：[1]梅州市人民医院肛肠外科,广东梅州514000

出　　处：《结直肠肛门外科》2014年第6期383-385,共3页Journal of Colorectal & Anal Surgery

摘　　要：目的探讨经骶尾部入路治疗骶前发育性囊肿临床效果。方法选择2005年1月至2012年10月骶前发育性囊肿患者19例,均实施经骶尾部入路治疗,囊肿体积测量2cm×2cm^16cm×18cm,平均直径为(8.28±3.18)cm,其中11例实施改良Kraske术式,8例实施Mason术式,治疗后随访两年,观察复发情况,并统计患者手术指标,包括术中出血量、手术时间、术后并发症。结果所有患者术后病理显示均为良性肿瘤,其中畸胎瘤11例,表皮样囊肿5例,皮样囊肿3例;改良Kraske术式手术时间121~163min,平均(136.93±24.29)min,术中出血量159~224mL,平均(186.29±35.12)mL,术后静脉出血1例(9.09%),切口感染1例(9.09%),并发症发生率18.18%;Mason术式手术时间92~125 min,平均(106.54±21.76)min,术中出血量135~171mL,平均(126.25±12.83)mL,术后切口感染1例(9.09%);所有患者术后随访18~24个月,平均(22.94±2.10)个月;1例患者出现复发,复发率5.26%,再次实施骶尾部入路手术治疗成功。结论经骶尾部入路治疗骶前发育性囊肿彻底、复发率低,同时并发症少安全性高,临床可优先选择此术式治疗。Objective To investigate the clinical results of the treatment for developmental cysts with anterior sacral sacral approach,and provide a reference for clinical selection of surgical procedures.Methods 19 cases of sacral developmental cysts were selected from January 2005 to October 2012,they were implemented by the sacral therapy approach,cyst volume measuring was 2×2cm^16×18cm,mean volume diameter was（8.28±3.18）cm,of which 11 cases were implemented with improved Kraske,8cases was implemented with Mason surgery,and after two years of follow-up treatment,recurrence was observed,and statistical indicators in patients with surgery,including blood loss,operative time,postoperative complications were investigated.Results All patients showed benign pathology,including 11 cases of teratoma,five cases of epidermoid cyst,three cases of dermoid cyst;improved Kraske surgical operation time was 121~163min,the average time was（136.93±24.29）min,blood loss was 159~224ml,average was（186.29±35.12）ml,1case had venous bleeding complications（9.09%）,one case had wound infection（9.09%）,the incidence was 18.18%;Mason surgical operation time was 92~125min,the average time was（106.54±21.76）min,blood loss was 35~71ml,average blood loss was（56.25±12.83）ml,one case had wound infection（9.09%）;All patients were followed up for 18 to 24 months,the average time was（22.94±2.10）months;recurrence rate was 5.26%,who had successful surgical treatment of sacral approach again.Conclusion The treatment of anterior sacral sacral approach for developmental cysts has good clearance function,the recurrence rate is low with fewer complications and good safety,this surgical treatment should be preferred clinically.

关 键 词：骶前发育性囊肿 手术 诊断 

分 类 号：R738[医药卫生—肿瘤]