全盆腔脏器切除术治疗侵及多脏器晚期盆腔内肿瘤的临床研究

目的　探讨侵犯周围脏器的盆腔内进展期肿瘤行全盆腔脏器切除术 (TPE)的可行性。方法　回顾性分析行TPE的 32例侵犯周围脏器的盆腔内进展期肿瘤患者的临床资料 ,并在生存率、体重改变、疼痛的缓解、病人对生活质量的满意度等方面同同期未行全TPE的 2 7例患者进行比较。结果　全组无围手术期死亡 ,并发症发生率为 2 2 % ,3年、5年生存率分别为 6 6 % ,38% ,而未行TPE组分别为 2 2 % ,4 % ,并且在生活质量、体重改变、疼痛缓解及预防等方面 ,全盆腔脏器切除术病人明显优于未行全盆腔脏器切除术病人 (P <0 .0 1)。结论　对于侵犯周围脏器的盆腔内进展期肿瘤患者 ,只要没有远处转移、腹膜种植和淋巴结广泛转移等不能治愈的因素 ,都应争取行TPE。

Clinical Study of Total Pelvic Exenteration for Intrapelvic Tumor Extending to Adjacent Organs

Objective To investgate the feasibility of total pelvic exenteration(TPE) for advanced intrapelvic tumor extending to adjacent organs.Methods The clinical data of the 32 cases undergone TPE with advanced intrapelvic tumor extending to adjacent organs were analyzed respectively, and compared these patiens with 27 cases which were not undergone TPE in 3 and 5 year survival rate, life quantity, weight change, pain remission and prevention.Results None of the 32 cases died during the perioperative period, the rate of complication was 22%, 3 and 5 year survival rates were 66% and 38%, but they were 22% and 4% in patiens which were not undergone TPE, moreover it was better in the patiens undergone TPE in life quantity,weight change,pain remission and prevention obviously (P<0.01).Conclusion TPE should be undergone for the patiens with advanced intrapelvic tumor extending to adjacent organs if there hadn't incurable factors such as distant metastasis,peritoneal dissemination and widespread nodal involvement.