原发性腹膜后脂肪肉瘤切除术中联合肠切除的临床疗效分析  

Primary retroperitoneal liposarcoma surgery in combination of bowel resection,a report of 24 cases

作　　者：陈骏 烟楠楠 冯丽丽 肖萌萌 黄梅 陈小兵 罗成华[1] Chen Jun;Yan Nannan;Feng Lili;Xiao Mengmeng;Huang Mei;Chen Xiaobing;Luo Chenghua(Department of Retroperitoneal Tumor Surgery,Peking University International Hospital,Beijing 102206,China)

机构地区：[1]北京大学国际医院腹膜后肿瘤外科,102206

出　　处：《中华普通外科杂志》2020年第10期778-781,共4页Chinese Journal of General Surgery

基　　金：国家卫生健康委医药卫生科技发展研究中心项目(WA2020RW29)。

摘　　要：目的分析原发性腹膜后脂肪肉瘤切除术中联合肠切除的临床疗效。方法回顾性分析2015年1月至2019年7月北京大学国际医院腹膜后肿瘤外科手术的原发性腹膜后脂肪肉瘤术中联合肠切除术的24例患者的临床资料。结果本组24例患者均接受肿瘤切除术合并肠切除术,其中行右半结肠切除6例,左半结肠切除8例,乙状结肠切除6例,直肠切除2例,小肠切除8例。术中和术后并发症发生率为38%,其中发生吻合口瘘2例,无手术死亡病例。术后病理结果提示高分化脂肪肉瘤11例,去分化脂肪肉瘤13例,其中肠壁明确有肿瘤侵犯18例。所有患者均得到随访,中位随访时间25个月,其中8例复发,3例死亡,2年总生存率和无疾病进展生存率分别为91%和71%,病理类型为去分化脂肪肉瘤是影响无疾病进展生存率的唯一危险因子(Z=2.02,P=0.042)。结论原发性腹膜后脂肪肉瘤合并肠切除相对安全,并发症发生率低,可以有效预防肿瘤残留。病理类型为去分化脂肪肉瘤患者的预后不良。Objective To evaluate primary retroperitoneal liposarcoma surgeries in combination with involved bowel resection.Methods Clinical data of primary retroperitoneal liposarcoma patients admitted for surgery at Peking University International Hospital from Jan 2015 to July 2019 were retrospectively reviewed.Results Twenty-four patients undergoing resectional surgeries combining with bowel resection were included for the study,of which 6 cases underwent right hemicolectomy,8 did left hemicolectomy,6 did sigmoidectomy,2 did proctectomy and 8 did small bowel resection.The post operative morbidity was 38%.2 of 24 had anastomotic fistula.There was no mortality.Final pathology disclosed well differentiated liposarcoma in 13 and dedifferentiated liposarcoma in 11 cases.18 cases were confirmed with bowel infiltration pathologically.All patients were followed up after the surgery.After a median of 25 months following up,8 cases developed recurrences and 3 deceased.Two-year overall survival and progression free survival probability were 91% and 71% respectively.Dedifferentiated liposarcoma as a pathological type was found as the only risk factor associated to poor progression free survival(Z=2.02,P=0.042).Conclusion Combining resection of primary retroperitoneal liposarcoma with involved bowel was relatively safe,with low morbidity,increasing tumor clearance.Dedifferentiated liposarcoma is associated wth poor prognosis.

关 键 词：脂肪肉瘤 腹膜后肿瘤 肠切除 

分 类 号：R735.4[医药卫生—肿瘤]