原发性腹膜后肿瘤57例分析

目的探讨原发性腹膜后肿瘤的诊断及治疗。方法1990—2004年经手术和病理证实的原发性腹膜后肿瘤57例,就其年龄、临床表现、辅助检查、病理类型及手术方式进行比较。结果首发症状及体征多数为腹痛及腹块。良性肿瘤23例,占40%,恶性肿瘤34例,占60%,平均病程21.6个月,70%恶性肿瘤病程多在1年以内,良性肿瘤病程多在1年以上。术前确诊率为68%,B超及CT的诊断率分别为81.3%,90.9%。本组良性肿瘤切除率91.3%,恶性肿瘤32.4%,术后复发6例,3例再次行根治术。结论本病早期缺乏典型症状,临床早期诊断困难,B超、CT等影像学检查是本病诊断的重要手段。手术切除是治疗的主要手段,对侵犯脏器者采用累及脏器一并切除,不能切除和切除后再发的主张探查活检和再次手术或多次手术切除。

Analysis of 57 Cases of Primary Ropperitonral Tumor

Objective To investigate the diagnosis and therapy of primary retroperitonral tumor.Methods 57 cases of primary retroperitonral tumor which were validated by operation and pathology.Comparing the difference of ages,clinical representations,assistant inspection,pathological styles and operation modes.Results The first symptom and signs are always bellyache and belly-tumor.In all cases,there are 23 benign tumor(40%),34 virulent tumor(60%), average time of course of diseases is 21.6 months.Course of diseases of 70% cases of virulent tumor are less than 1 year,and much caseas of benign tumor are more than 1 year.Rate of diagnose before operation is 46.8%,Rae of diagnose by Bstyle ultrasonic and computerized tomography are 81.3% and 90.9%.Resection rate of benign tumor is 93.2%,and virulent tumor is 42.2%,6 cases recrudescee after operation,in which 3 cases were radically reopefated.Conclusion There aren't typical symptoms in the early stage of PRT,so it is difficult to diagnose,inspection of B style ultrasonic and CT ect.are important methods.The mostly way of curing PRT is operation.The total resection of other implicated organs is the best way of treatment,patients with recurrent can be treated with byospy and reoperation.