成人骶尾部成熟型囊性畸胎瘤合并消化系统症状28例临床分析  

Mature cystic sacrococcygeal teratoma in adults with digestive system symptoms:Analysis of 28 cases

作　　者：王宇 唐月翠 王明 刘洪俊 李乐平 郭晓波 Yu Wang;Yue-Cui Tang;Ming Wang;Hong-Jun Liu;Le-Ping Li;Xiao-Bo Guo(Department of Gastrointestinal Surgery,Shandong Provincial Hospital Affiliated to Shandong First Medical University,Jinan 250021,Shandong Province,China;Department of Gastrointestinal Surgery,Heze Hospital,Shandong Provincial Hospital,Heze 274000,Shandong Province,China)

机构地区：[1]山东第一医科大学附属省立医院胃肠外科,山东省济南市250021 [2]山东省立医院菏泽医院,山东省菏泽市274000

出　　处：《世界华人消化杂志》2025年第2期158-168,共11页World Chinese Journal of Digestology

基　　金：国家自然科学基金资助项目,No.81672379.

摘　　要：背景成熟型囊性骶尾部畸胎瘤在成人中极为罕见,目前还较为缺乏临床研究和文献报道,相关研究仍是临床关注重点.本研究对手术治疗的28例成人成熟型囊性骶尾部畸胎瘤进行临床效果分析,为以后胃肠外科医生手术治疗提供依据.目的回顾性分析成人成熟型囊性骶尾部畸胎瘤手术治疗的临床疗效.方法回顾性分析2018-01/2024-11在山东第一医科大学附属省立医院收治的28例成人成熟型囊性骶尾部畸胎瘤患者的临床资料,所有患者均行手术切除,通过观察患者的手术方式、术中骶尾骨切除情况、术中有无过多出血(≥400 mL)、术后有无肠瘘、有无骶尾部刀口坏死及肿瘤复发等情况,对术后治疗效果进行分析.随后通过手术方式不同分为A组(n=5,腹腔镜辅助前入路术式),B组(n=10,后入路术式)和C组(n=13,腹腔镜联合后入路术式),通过对照研究对术后并发症及复发情况进行对比分析,并根据骶尾骨是否切除将样本独立分为E组(n=21,骶尾骨切除组)与F组(n=7,骶尾骨未切除组),分析骶尾骨切除与肿瘤复发的关系.此外并对患者术后消化系统功能恢复情况发表相关看法.结果28例患者均完成手术切除,术后病理均为成熟型囊性畸胎瘤.5例行前入路(经腹腔镜辅助下)手术切除,10例行后入路手术切除,13例行腹腔镜联合后入路手术切除,术后住院期间发生肠瘘者3例,骶尾部刀口局部坏死者8例,其余患者均恢复良好.术后28例患者获得全部随访,1例患者术后10 mo死于后腹膜转移,另有4例于6 mo-24 mo内复发,其中有3例均为未行骶尾骨切除患者,经再次手术并切除骶尾骨后痊愈,至今无复发迹象.其余患者均恢复良好无复发.另外,3种不同的手术方式在术中出血≥400 mL、肠瘘、骶尾部刀口坏死、及肿瘤复发率上无明显统计学差异.骶尾骨是否切除对肿瘤复发有明显统计学差异(P<0.05).结论成人成熟型囊性骶尾�BACKGROUND Mature cystic sacrococcygeal teratoma(SCT)is exceedingly rare in adults,with limited clinical studies and literature available.This study examined the clinical outcomes of 28 adult patients with mature cystic SCT treated surgically,aiming to provide a foundation for optimizing surgical strategies for this rare condition.AIM To retrospectively evaluate the clinical effectiveness of surgical treatment for mature cystic SCT in adults with digestive system symptoms.METHODS The clinical data of 28 adult patients with mature cystic SCT,admitted to the Provincial Hospital of Shandong First Medical University between January 2018 and November 2024,were retrospectively analyzed.All patients underwent surgical resection.The analysis included evaluation of surgical methods,intraoperative sacrococcygeal resection,excessive intraoperative hemorrhage(≥400 mL),post-operative complications such as intestinal fistula and sacrococcygeal incision necrosis,and tumor recurrence.The patients were then divided into Group A(n=5,laparoscopic-assisted anterior approach),Group B(n=10,posterior approach),and Group C(n=13,combined laparoscopic and posterior approach)based on the surgical modality used,and comparative analyses of postoperative complications and recurrence were conducted through controlled studies.Additionally,the samples were divided into Group E(n=21,sacrococcygeal resection group)and Group F(n=7,sacrococcygectomy group)independently according to whether sacrococcygectomy was performed or not,to analyze the relationship between sacrococcygectomy and tumor recurrence.In addition,the patient’s postoperative recovery of digestive system function was discussed.RESULTS Surgical resection was completed in all the 28 patients,and postoperative pathology showed mature cystic teratoma in all of them.Of the 28 cases included,five were managed via an anterior approach assisted by laparoscopy,10 via a posterior approach,and 13 via a combination of laparoscopic and posterior approach.Postoperative complications included th

关 键 词：成人 骶尾部 成熟型 畸胎瘤 手术 消化系统 

分 类 号：R73[医药卫生—肿瘤]