盆部腹膜外软组织肿瘤88例临床治疗

Extraperitoneal pelvic soft tissue neoplasms: an analysis of 88 cases

目的 探讨盆部腹膜外软组织肿瘤的临床特征及诊治经验。方法 回顾性分析盆部腹膜外软组织肿瘤 88例的临床资料。结果 88例盆部腹膜外软组织肿瘤最大 30cm× 30cm× 2 5cm ,受累脏器包括髂血管、直肠、膀胱输尿管、子宫附件、盆壁骨骼肌肉神经等。最常见病理类型为畸胎瘤及神经鞘瘤。主要症状为疼痛、排便排尿困难、下肢感觉运动障碍等。腹部及肛门指诊扪及肿块者分别为 4 9例及 5 1例。B超、CT、MRI检查发现盆部肿块百分比为 97%、10 0 %、91%。 88例患者共行 110例次手术 ,肿瘤全切除率 95 5 %。 4例行人工血管移植 ,3例行全盆腔脏器切除。本组无手术死亡 ,并发症发生率 5 5 %。结论 盆部腹膜外软组织肿瘤可发生于盆腔腹膜外任何部位 ,可累及盆内任何脏器及盆壁结构 ,必要时需施行联合脏器切除。分次手术及复发肿瘤的再手术对提高肿瘤切除率 ,改善预后具有重要意义。

Objective To evaluate clinical features and management of extraperitoneal pelvic soft tissue neoplasms. Methods Clinical data of 88 cases of extraperitoneal pelvic soft tissue neoplasms were retrospectively analyzed. Results Tumors were located in the posterior or lateral part or occupying the whole pelvic cavity, with the largest volume of 30 cm×30 cm×25 cm. The major presentations included pain, dysuria and difficult defection, sensorimotor disorder of lower limb, abdominal and pelvic mass. B-US, CT and MRI examinations revealed pelvic mass in 97%,100% and 91% of cases respectively. A total of 110 operations were carried out, with complete tumor resection rate of 95.5%. Four patients underwent vessel graft transplantation, and 3 total pelvic exenterations. There was no inhospital mortality and postoperative complications developed in 5.5% of cases.Conclusion Extraperitoneal pelvic soft tissue neoplasms may be located in any site and involve any organ of the pelvic cavity or the pelvic wall. Surgery is the most effective treatment including extended or combined resection of the involved pelvic visera.