腹膜后肿瘤包绕腹腔干治疗方案初步探讨  

The Discussion of Treatment of Retroperitoneal Tumors Infiltrating Celiac Trunk

作　　者：苗成利[1] 曾嘉[1] 陈建飞[2] 陈伟达[1] 梅世文[1] 何远翔[1] 罗成华[1] 

机构地区：[1]北京大学国际医院腹膜后肿瘤外科,北京102206 [2]北京大学国际医院肝胆外科,北京102206

出　　处：《中国普外基础与临床杂志》2016年第3期278-281,共4页Chinese Journal of Bases and Clinics In General Surgery

摘　　要：目的探讨腹膜后肿瘤侵犯腹腔干时的处理方法与原则。方法回顾性分析2014年12月至2015年12月期间北京大学国际医院收治的15例腹膜后肿瘤侵犯腹腔干患者的临床资料,并进行分析总结。结果15例患者均行手术治疗,术中出血量为300-2 200 mL,平均600 mL;手术时间为125-600 min,平均240 min。术后住院时间：未切除腹腔干患者为10-23 d,平均15.1 d;切除腹腔干患者为15-132 d,平均35.2 d。其中肿瘤完整切除者13例,大部分切除者2例。8例术中将腹腔干剥离,未损伤,术后发生并发症1例;7例切除或损伤了腹腔干,术后均发生了不同程度的并发症,其并发症发生率高于未切除腹腔干者（χ-2=8.14,P=0.01）。术后15例患者获访,随访时间为3-13个月,平均6.3个月。其中2例复发,1例为平滑肌肉瘤,1例为恶性纤维组织细胞瘤,此2例患者均为术中切除了腹腔干的患者。结论腹膜后肿瘤侵犯腹腔干时可切除腹腔干,但术后并发症较多,需按一定的原则进行处理。Objective To discuss the treatment of retroperitoneal tumors infiltrating celiac trunk. Methods Fifteen cases of retroperitoneal tumors who underwent surgery in our hospital between December 2014 to December 2015 were reviewed and analyzed. Results All of the 15 cases had underwent operation, and the blood loss was 300-2200 mL（mean of 600 mL）, operation time was 125-600 minutes（mean of 240 minutes）. Length of stay in cases of celiac trunk resected was 10-23 days（mean of 15.1 days）, and length of stay in cases of celiac trunk nonresected was 15-132 days（mean of 35.2 days）. Thirty cases of them were complete resection, and 2 cases were mostly resection. Eight cases of them did not injure celiac trunk, 1 case suffered from complication, 7 cases injured celiac trunk and all of them suffered from complication. There were significant statistical difference in incidence of complications（χ-2=8.14, P=0.01） in cases of celiac trunk injury or not. All the cases were followed up for 3-13 months（mean of 6.3 months）, 2 cases recurred during the follow-up period, 1 case was leiomyosarcoma, and another 1 was malignant fibrous histiocytoma who underwent celiac trunk resection. Conclusion When retroperitoneal tumors infiltrates celiac trunk, we can resect the celiac trunk, but we must follow a certain principle.

关 键 词：腹膜后肿瘤 腹腔干 并发症 

分 类 号：R735.4[医药卫生—肿瘤]