盆腔腹膜后肿瘤手术治疗的临床分析  

Experiences in surgical treatment of pelvic retroperitoneal neoplasms

作　　者：唐茂盛 苗成利[1] 陈小兵 邹博远 刘世博 高海成 罗成华[1] Tang Maosheng;Miao Chengli;Chen Xiaobing;Zou Boyuan;Liu Shibo;Gao Haicheng;Luo Chenghua(Department of Retroperitoneal Tumors,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》2021年第9期668-671,共4页Chinese Journal of General Surgery

基　　金：国家卫生计生委医药卫生科技发展研究中心项目(WA2020RW29)。

摘　　要：目的:总结盆腔腹膜后肿瘤的手术治疗经验。方法:回顾性分析2015年4月至2020年9月北京大学国际医院行手术治疗107例盆腔腹膜后肿瘤患者的临床病理资料。根据肿瘤的位置、大小、与周围组织的关系个体化制定手术方案,分析患者的基本情况、出血量、肿瘤大小、是否初次手术及联合脏器切除等对手术并发症的影响。结果:手术路径包括前入路67例,骶尾侧入路21例,腹骶联合入路13例,腹腔镜5例。29例患者行联合脏器切除,27例患者发生术后并发症,严重并发症包括结直肠吻合口瘘6例,尿瘘6例,盆底延迟愈合6例,直肠阴道瘘3例,术后出血2例。是否初次手术与并发症的发生有关(χ2=4.79,P<0.05)。结论:对盆腔腹膜后肿瘤需充分做好术前准备及个体化设计,术中结合多种控制出血的措施及联合脏器的切除能够有效提高切除率,保障手术安全。Objective To summarize the experience of surgical treatment of pelvic retroperitoneal neoplasms.Methods A total of 107 patients with pelvic retroperitoneal neoplasms underwent surgical treatment from Apr 2015 to Sep 2020.According to the neoplasm location,size,and the relationship with the surrounding tissues,individualize the surgical plan,analyze the patient's basic condition,bleeding volume,tumor size,whether it is the first operation,or combined organ resection,etc.to find out the relevant factors affecting the surgical complications.Results The surgical route included anterior approach in 67 cases,sacrococcygeal approach in 21 cases,combined abdominal-sacral approach in 13 cases,and laparoscopy in 5 cases.Twenty-nine patients underwent combined organ resection,postoperative complications occurred in 27 patients including colorectal anastomotic leakage in 6 cases,urinary fistula in 6 cases,delayed pelvic floor healing in 6 cases,rectovaginal fistula in 3 cases,and postoperative bleeding in 2 cases.The statistical analysis show whether or not first operation is related to the occurrence of complications(χ2=4.79,P<0.05)Conclusion Pelvic retroperitoneal neoplasms need to be fully prepared before surgery and individualized design.Intraoperative combined bleeding control measures and combined organ resection can effectively increase the resection rate and ensure the safety of surgery.

关 键 词：腹膜后肿瘤 盆腔肿瘤 手术后并发症 

分 类 号：R730[医药卫生—肿瘤]