原发性腹膜后肿瘤术前介入治疗在外科手术中的意义

目的探讨原发性腹膜后肿瘤术前介入治疗在减少手术出血量、提高完整切除率和降低手术死亡率中的意义。方法回顾性分析2004-10-2013-12行原发性腹膜后肿瘤手术患者48例,以术前介入治疗＋手术12例作为试验组,直接手术36例作为对照组。观察指标包括手术出血量、完整切除率和手术死亡率。结果试验组12例均顺利完成手术,其中完整切除肿瘤10例,无手术死亡病例,术中出血量为（1976.67±273.34）ml。对照组33例顺利完成手术（完整切除肿瘤18例）,1例术中死亡,2例术后死亡,术中出血量为（2597.22±801.24）ml。试验组的术中出血量比对照组少（P〈0.05）,肿瘤完整切除率比对照组的高（P〈0.05）。两组手术死亡率比较差异无统计学意义（P〉0.05）。结论原发性腹膜后肿瘤术前介入治疗可减少手术出血量,提高完整切除率,对手术死亡率则不具有影响。

The significance of preoperative interventional treatment in the surgery of primary retroperitoneal neoplasm

Objective To study the significance of preoperative interventional treatment of primary retroperitoneal neoplasm in reducing bleeding,improving complete resection rate and reducing surgical-associated mortality.Methods Clinic data were analyzed on surgical cases of primary retroperitoneal neoplasm retrospectively from October 2004 to December 2013. Forty-eight cases were selected in this study,including 12 preoperative interventional treatment cases（ experimental group） and 36 non-preoperative interventional treatment cases（ control group） respectively. The clinical indexes included volume of bleeding,completed resection rate and surgical-associated mortality rate. Results In the experimental group,10 cases were achieved completed tumor resection and 2 cases palliative tumor resection. There was no death in this group. The volume of bleeding was（ 1976. 67 ± 273. 34） ml. In the control group,18 cases were achieved completed resection,18 cases palliative tumor resection. One case was died of large bleeding in the operation,and 2 cases died of MODS postoperatively. The volume of bleeding was（ 2597. 22 ±801. 24） ml. In the experimental group,the volume of bleeding was less（ P〈0. 05） and the complete resection rate was higher than that in the control group（ P〈0. 05）. There was no significant differences between two groups in surgical-associated mortality rate（ P〉0. 05）. Conclusion This results indicate that preoperative interventional treatment can reduce operative bleeding and improve complete resection rate for primary retroperitoneal neoplasm. However,preoperative interventional treatment does not seem to affect the surgical-associated mortality rate in these study.