原发性腹膜后肿瘤108例临床分析

目的：探讨原发性腹膜后肿瘤的诊断和治疗方法。方法：分析1993－2000年在我院治疗的原发性腹膜后肿瘤共108例临床资料特点，与同期国内文献资料相比较。结果：肿瘤排名情况与国内资料相近，半数病例以腹部肿块、腰腹胀痛为首发症状；肿瘤复发和转移导致预后不佳，半数以上失去手术机会；近年来B超、CT、MRI等已经成为临床诊断的重要手段；我院的手术切除率较高，并对残留病灶和肝转移灶进行新的治疗探索。结论：临床对较大腹块伴持续腰腹胀痛的病例应高度警惕原发性腹膜后肿瘤可能，B超、CT、MRI对肿瘤的定位更为准确，敏感度和特异性俱佳，对制定手术方案具有重要价值，而介入影像学具有发展潜力；手术切除仍为治疗原发性腹膜后肿瘤的首选方法，提高首次手术的完整切除率对减少或推迟术后复发具有重要意义；复发病例只要无手术禁忌，均应再次剖腹探查，尽可能切除肿瘤。

Clinical Study of Primary Retroperitoneal Tumor: A Report of 108 Cases

Objective: To investigate the methods in the diagnosis and treatment of primary retroperitoneal tumors(PRT). Methods: 108 cases with PRT treated from 1993 to 2000 were analyzed retrospectively. Results: The range of the incidence was similar to the former reports, clinical manifestation indicated that half of the cases got abdominal mass and pain as the earliest symptom. Tumor with recurrence or metastasis leads to worse prognosis, half of them became inoperative. In recent years, B-mode ultrasonography, CT, MRI become the most important methods in clinical diagnosis. We had got a higher resection rate and tried new methods in treating unresectable tumors and liver metastases. Conclusion: Patients with large abdominal mass and pain should be considered as the possible of PRT. B-mode ultrasonography, CT, MRI make a better definition in the diagnosis and operation planning. En bloc resection is the treatment of choice for most of the patients. The opportunity of exploration should be given to the recurrent cases without contraindication.