原发性腹膜后肿瘤诊断和治疗（附81例报告）

目的　探讨原发性腹膜后肿瘤 (PRT)的诊断与外科治疗经验。方法　分析 1980～2 0 0 0年共收治的 81例原发性腹膜后肿瘤。其中良性 34例 ,恶性 47例 ,均经组织病理学证实 ,77例施行手术治疗。观察腹膜后肿瘤在临床表现、影像学检查、病理类型、手术切除及复发等方面的特点。结果　B型超声、CT检查有助于原发性腹膜后肿瘤的早期发现。良性腹膜后肿瘤病程长 (17.5个月 ) ,完整切除率高 (85 .2 9% ) ,很少合并脏器切除 (17.6 5 % ) ;而恶性肿瘤病程短 (7.3个月 ) ,完整切除率低 (6 5 .12 % ) ,合并脏器切除率高 (2 7.91% )。腹膜后肿瘤复发率 19.30 % ,复发完整切除率达6 3.6 3%。结论　B型超声及CT检查是诊断本病的主要手段 ,手术完整切除肿瘤是治疗的主要手段 ,对复发肿瘤亦应争取再次手术。

Diagnosis and treatment of primary retroperitoneal tumors-A report of 81 cases

Objective To summarize the experience in diagnosis and treatment of primary retroperitoneal tumor (PRT). Methods Eighty one cases of PRT diagnosed pathologically and treated from 1980 to 2000 were analyzed. Among them, 34 cases were benign tumors and 47 malignant one. Seventy seven cases underwent surgical operation. Clinical manifestations, imaging findings, pothological types, operative resection and recurrent rate were observed. Results B ultrasonic and CT examination contributed to the early diagnosis of PRT. Benign tumors had longer duration ( 17.5 months), high complete excision rate ( 85.29% ) and rare resection of adjacent organs ( 17.65% ). While malignant tumor had shorter duration ( 7.3 months), lower complete excision rate ( 65.12% ) and higher en bloc rate with adjacent organs ( 27.91% ). The recurrent rate of PRT was 19.30% and the complete excision rate of re operation was 63.63% . Conclusions B ultrasonic and CT examination was a common way for the diagnosis of PRT. The complete resection was regarded as a main surgical strategy for the treatment of PRT. Re operation was the first choice for recurrent PRT.