原发性腹膜后肿瘤的外科治疗(附85例报告)

目的探讨和总结原发性腹膜后肿瘤的手术治疗经验。方法回顾性分析1993年1月至2005年9月经手术治疗的85例原发性腹膜后肿瘤,分析总结其病理学类型、影像学检查、外科手术治疗等临床资料。结果良性肿瘤33例,恶性肿瘤51例,交界性肿瘤1例,均经手术治疗且病理证实。良性肿瘤完整切除31例(93.94%);恶性肿瘤完整切除39例(76.47%);交界性肿瘤行完整切除。手术中联合脏器切除共20例,其中良性2例,恶性18例。良性肿瘤术后复发再手术4例,均完整切除;恶性肿瘤术后复发再手术19例,完整切除14例,部分切除3例,探查活检2例。结论影像学检查对术前诊断和手术切除范围有重要意义。手术完整切除肿瘤是治疗的关键因素。再次手术仍是治疗复发性腹膜后肿瘤的有效手段。

Surgical treatment of primary retroperitoneal tumor: report of 85 cases

Objective To explore and summarize the experience of surgical treatment of primary retroperitoneal tumor(PRT).Methods Clinical data of 85 patients with PRT treated from January 1993 to September 2005 were retrospectively analyzed including image examination,pathologic examination and surgical procedure.Results 33 cases of benign PRT,51 malignant PRT and 1 borderline tumor were diagnosed by operation and postoperative pathologic examination.Of the 33 patients with benign tumor,31 underwent complete resection(93.94%) with adjacent organ resection in 2 cases.Of the 51 patients with malignant tumor, 39 underwent complete resection(76.47%) with adjacent organ resection in 18 cases.One patient with borderline tumor underwent total resection with no adjacent organ excision.4 cases of recurrent benign PRT underwent complete resection.In 19 cases of recurrent malignant PRT,14 cases underwent complete resection,3 partial resection and 2 only biopsy.Conclusions Preoperative image examination is crucial for the diagnosis and the evaluation of the operative resectability.Complete resection is the key for the treatment of PRT.Reoperation is the effective treatment for the recurrent tumor.