尾肠囊肿42例临床分析  

Clinical analysis of tailgut cyst:report of 42 cases

作　　者：石娜 徐辰一 周文倩 丁康[2] 王康 Shi Na;Xu Chenyi;Zhou Wenqian;Ding Kang;Wang Kang(Department of Pathology,Nanjing Hospital of Traditional Chinese Medicine,Nanjing210000,China;Department of Anorectal,Nanjing Hospital of Traditional Chinese Medicine,Nanjing210000,China)

机构地区：[1]南京市中医院病理科,南京210000 [2]南京市中医院肛肠科,南京210000

出　　处：《中华普通外科杂志》2024年第11期844-849,共6页Chinese Journal of General Surgery

摘　　要：目的探讨尾肠囊肿的临床病理特征及治疗转归。方法回顾性分析2012年1月至2024年3月在南京市中医院肛肠科接受诊治的42例尾肠囊肿患者的临床病理资料。结果本组42例患者中男14例,女28例,中位年龄51岁(23~76岁)。19例出现会阴部和(或)腹部疼痛,13例出现肛周肿胀,10例出现肛周脓肿,7例出现骶尾部窦道,4例有肛门肿物,以上症状常合并出现。42例病变位置均位于直肠后,其中相对于尾骨的位置:位于尾骨以上7例、尾骨以下17例、尾骨上下11例、尾骨水平7例;相对于盆底位置:肛提肌以上3例、肛提肌以下17例、肛提肌上下22例。41例采用后入路手术,1例采用联合入路手术。囊肿切面呈单房32例,多房10例。女性病例呈多房者明显比男性多见(P<0.05),而肿瘤位置、肿瘤大小、复发、良恶性均与性别无关(均P>0.05)。术后8例(19%)复发,5例恶变患者为多次复发且病程较长。结论尾肠囊肿罕见,多见于女性,可以引起会阴部、腹部疼痛、肛周肿胀、肛周脓肿及其他非特异性症状,多次复发病例易发生恶变,需根据肿瘤的大小、位置以及与邻近组织的关系,选取合适的手术路径进行完整切除。ObjectiveExploring the clinical characteristics and treatment outcomes of tailgut cysts,and improving the understanding of this disease.MethodsA retrospective analysis of 42 patients with tailgut cyst surgically treated from Jan 2012 to Mar 2024 was conducted.ResultsThis study included 42 patients(28 females,14 males)with a median age of 51(23-76)years old.Nineteen cases of perineal/abdominal pain,13 cases of perianal swelling,10 cases of perianal abscess,7 cases of sacrococcygeal sinus,and 4 cases of anal mass were observed.These symptoms often occurred simultaneously.All 42 patients had lesions located behind the rectum,with a relative position to the coccyx(7 above the coccyx,17 below the coccyx,11 above and between the coccyx levels,and 7 horizontally).Tailgut cysts were located in the pelvic floor,with 3 cases above the levator ani muscle,17 cases below the levator ani muscle,and 22 cases between the levator ani muscle levels.Forty-one cases were treated with posterior approach,and 1 case was treated with combined approach.Thirty-two were unilocular and 10 multilocular.Female patients with multiple compartments were significantly more common than males(P<0.05),while tumor location,tumor size,recurrence,and malignancy were all independent of gender.After surgery,8 cases(19%)experienced recurrences and 5 cases of malignant transformation patients had a long term multiple relapses.ConclusionsTailgut cysts are rare,while women were common seen.Non-specific symptoms of pain in the perineum or abdomen,perianal swelling or abscess,are usually observed.In addition,multiple relapses could have malignant transformation.Surgical complete resection is the most reasonable treatment method and the appropriate surgical path should be selected based on the size,location,and relationship with adjacent tissues of the tumor.

关 键 词：尾肠囊肿 错构瘤 

分 类 号：R735.3[医药卫生—肿瘤]