原发性腹膜后肿瘤42例的外科治疗

目的 探讨原发性腹膜后肿瘤（PRT）的诊断、治疗以及复发性腹膜后肿瘤的预防、治疗要点。方法 对1990－2000年手术且病理证实的42例原发性腹膜后肿瘤进行回顾性分析。结果 42例中良性19例，恶性23例。19例良性肿瘤完整切除15例，合并脏器切除3例，肿瘤部分切除1例，复发后再手术完整切除。23例恶性肿瘤完整切除9例，合并脏器切除11例，部分切除及探查活检3例。复发后再次及多次手术5例。全组无手术死亡。结论 影像学检查是判断手术切除范围的重要依据。施行肿瘤全切除术是治疗PRT的关键。对于复发性腹膜后肿瘤，外科手术切除仍是主要治疗手段。对多次复发的肿瘤不应放弃手术机会。

Surgical treatment of primary retroperitoneal tumor:report of 42 cases

ObjectiveTo study the diagnosis and treatment of primary retroperitoneal tumor ( PRT) and the key for preventing and treating of recurrent retroperitoneal tumor (PRT).MethodsThe clinical data of 42 patients with PRT operated on from 1990 to 2000 were retrospectively analyzed.ResultTumors were benign in 19 patients and malignant in 23. Of the 19 patients with benign tumor, 15 underwent complete resection with incidental organ resection in 3 cases, palliative resection in 1 case, and complete resection of recurrent tumor in one. Of the 23 malignant tumors, complete resection was performed in 9 cases, complete resection with incidental organs resection in 11 cases, biopsy only in 3 cases. There was no operative death.ConclusionPreoperative imaging results are gists on which the resectability is judged, and complete resection is the only hope of cure. Surgical resection is the therapy of choice for postoperative recurrent PRT.