37例巨大腹膜后脂肪肉瘤患者的临床资料分析  

Giant retroperitoneal liposarcoma:an analysis of 37 cases

作　　者：林佳鑫 刁德昌[2] 廖伟林 汪佳豪 李洪明[2] 易小江 卢新泉 冯晓创 陈昭宇 Lin Jiaxin;Diao Dechang;Liao Weilin;Wang Jiahao;Li Hongming;Yi XiaoJiang;Lu Xinquan;Feng Xiaochuang;Chen Zhaoyu(The Second Clinical Medical School,Guangzhou University of Chinese Medicine,Guangzhou 510405,Guangdong,China;Gastrointestinal Cancer Center/Department of Colorectal Surgery,Guangdong Provincial Hospital of Traditional Chinese Medi-cine,Guangzhou 510120,Guangdong,China)

机构地区：[1]广州中医药大学第二临床医学院,广东广州510405 [2]广东省中医院胃肠肿瘤中心/结直肠外科,广东广州510120

出　　处：《结直肠肛门外科》2022年第2期124-128,共5页Journal of Colorectal & Anal Surgery

基　　金：广州市科技计划项目(202102010240)。

摘　　要：目的分析腹膜后脂肪肉瘤(RPLS)患者的临床资料,总结临床诊疗经验。方法回顾性分析2019年1月至2021年12月广东省中医院收治的37例巨大RPLS患者的临床资料,患者肿瘤最大径均在10 cm以上。结合患者病史,将其分为初治组(n=17)与局部复发组(n=20)。记录患者手术相关情况及随访结果。结果有33例行肿瘤完整切除(含初治组16例、局部复发组17例),初治组手术时间、术中出血量分别为181.5(147.0,272.8)min、100.0(27.5,400.0)m L,局部复发组相应为260.0(115.0,417.5)min、700(100,1500)m L,初治组行脏器联合切除及术后发生并发症的患者分别为11例、1例,局部复发组相应为13例、8例;其余4例患者因肿瘤周围脏器广泛受侵犯,或肿瘤包绕、侵犯腹主动脉和下腔静脉而接受姑息性切除。术后随访2~37个月,无失访患者。初治组与局部复发组的术后复发病例分别为1例、10例;共有6例患者因肿瘤复发死亡,均为局部复发组患者,其中2例接受姑息性切除。结论对于巨大RPLS,完善术前准备工作、注重手术技巧、术中整块完整切除腹膜后所有肿瘤灶是保障手术成功的前提与改善预后的关键,临床上应重视对术后患者进行有效管理。初治的RPLS应尽可能做到早诊早治及肿瘤完整切除,局部复发的RPLS需要结合更多临床因素综合制定治疗方案。Objectives To analyze the clinical features of patients with giant retroperitoneal liposarcoma and summarize clinical experiences.Methods This was a retrospective analysis of 37 patients with giant retroperitoneal liposarcoma treated at the Guangdong Provincial Hospital of Traditional Chinese Medicine between January 2019 and December 2021.All patients had a maximum tumor diameter>10 cm.Patients were divided into the initial treatment group(n=17)and the local recurrence group(n=20)depending on the patients’history.Patients’surgical parameters,and follow-up were recorded.Results Thirty-three patients had en bloc resection(16 in the initial treatment group and 17 in the local recurrence group).In the initial treatment group,the duration of surgery and intraoperative blood loss were 181.5(147.0,272.8)min and 100.0(27.5,400.0)m L,respectively.The corresponding figures in the local recurrence group were 260.0(115.0,417.5)min and 700(100,1500)m L.11 patients in the initial treatment group and 13 in the local recurrence group had multiple organ resections.1 patient in the initial treatment group and 8 patients in the local recurrence group had postoperative complications.Four patients had palliative resection due to multiple organs being affected or surrounded by the tumor,abdominal aorta or inferior vena cava invasion.Patients were followed up for 2to 37 months.No patients were lost to follow-up.Recurrence occurred in one patient in the initial treatment group and 10 in the local recurrence group.Six patients in the local recurrence group died due to recurrence,among whom two received palliative resection.Conclusion For patients with giant retroperitoneal liposarcoma,detailed preoperative planning,surgical techniques,and intraoperative en bloc resection of all retroperitoneal tumor foci are essential to successful surgery and good prognosis.Effective postoperative patient management also should be given attention.Early diagnosis and en bloc resection should be encouraged for initial retroperitoneal liposarcoma.For

关 键 词：腹膜后脂肪肉瘤 临床特征 诊疗方案 

分 类 号：R735.4[医药卫生—肿瘤]