外科治疗原发性腹膜后恶性肿瘤120例

目的探讨原发性腹膜后恶性肿瘤的外科治疗技巧。方法回顾性分析120例原发性腹膜后恶性肿瘤的临床资料，术前均行B超、CT或MRI检查，并行DSA8例，IVP 28例；行肿瘤根治性切除88例，姑息性切除18例，未切除14例。结果全组无手术死亡，术后发生肺部感染11例，切口感染9例，腹腔感染6例，切口裂开5例，术后出血4例，肠梗阻3例，并发症发生率为31．7％（38／120）。88例肿瘤根治性切除者1、3和5年累积生存率分别为100．0％、91．2％和25．1％，姑息性肿瘤切除者1、3和5年累积生存率分别为34．1％、27．7％和7．2％，两组比较差异有显著性（P〈0．05）。结论B超、CT、MRI和血管造影对判断肿瘤周围器官是否受累和切除范围有重要意义，外科手术切除肿瘤是提高原发性腹膜后恶性肿瘤生存率的最重要的手段，联合脏器切除能提高肿瘤的完整切除率，良好的手术技能是提高手术切除率的关键。

Surgical Treatment of Primary Retroperitoneal Malignant Tumor (120 Cases Report)

Objective To evaluate the therapeutic effects of the surgical treatment for primary retroperitoneal malignant tumor. Methods The clinical data of 120 primary retroperitoneal malignant patients were analyzed retrospectively. All the cases were examined by ultrasound, CT/MRI, and 8 cases of DSA, 28 cases of IVP. The surgical treatments were achieved in 88 cases of radical excision, 18 of palliated excision, and 14 of biopsy only. Results The 1-,3-, and 5-year overall survival rates of 88 cases with curative resection were 100.0% ,91.2% and 25.1% respectively, and the 1-,3-, and 5- year overall survival rates of 18 cases with palliative resection were 34.1% ,27.7% and 7.2% respectively. There were significant differences between the two groups （P 〈 0.05）. Conclusions It is important of B-ultrasonography, CT, MRI and DSA for the pre-operative evaluation in primary retroperitoneal malignant tumor. Surgical resection is an effective way for primary retroperitoneal malignant tumor, and multiple organs combined resection increases the success rate of tumor resection. Excellent surgical technique is the key to improve the tumor resection rate.