目的 总结原发性巨大腹膜后肿瘤(primary retroperitoneal tumor, PRT)的外科治疗及手术经验。方法 回顾性分析我院经手术治疗的巨大PRT(肿瘤直径＞10 cm)67例的临床资料。主要分析指标有手术方法、病理结果及术后并发症。结果 巨大PRT 67例均经病理确诊。良性39例, 恶性28例;完整切除56例, 姑息性切除术8例;肿瘤探查和活检3例;术后并发症13例。40例获得随访, 随访时间0.5～5年, 其中良性肿瘤18例, 原位复发4例;恶性肿瘤22例, 原位复发10例, 二次手术5例。结论 巨大PRT手术难度大, 风险高, 术前CT及MRI检查对判断肿瘤周围器官是否受累和切除范围有重要意义, 完整切除的关键在于周密的术前准备、确定肿瘤的毗邻关系及可能受侵的血管。
Abstract
Objective To study the surgical treatment of huge retroperitoneal tumor. Methods The clinical data of 67 surgical cases of huge retroperitoneal tumor (diameter>10 cm) between May 2009 and May 2014 were analyzed retrospectively. Results The pathological diagnosis was confirmed. They were benign (n=39) and malignant (n=28). 56 cases underwent total resection, 8 cases underwent palliative resection, 3 cases underwent tumor biopsy only. Among them, 40 cases were followed up for 6 months to 5 years, including 18 benign cases. Five cases had local recurrence. Among 22 malignant cases, local recurrence occurred in 10 cases. Three cases underwent secondary procedures. Conclusions Huge retroperitoneal tumors carry great surgical difficulties and risks. CT and MRI are very important for preoperative evaluation. Precise preoperative preparation such as iconographies should be done for the detection of the tumor and its blood supply.
关键词
巨大腹膜后肿瘤 /
诊断 /
外科治疗
Key words
huge retroperitoneal tumor /
diagnosis /
surgical procedures
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