原发性骶前肿瘤26例临床诊断与治疗

Diagnosis and treatment of primary presacral tumors:analysis of 26 cases

目的探讨原发性骶前肿瘤的诊断与手术治疗。方法分析1993年4月至2005年10月我院收治26例原发性骶前肿瘤的诊断和治疗情况,结合文献进行讨论。结果术前诊断主要依靠直肠指诊、B超、CT等相关检查。手术方法有:经骶尾部切除12例,经腹切除8例,经腹骶尾部联合入路切除6例。其中合并切除直肠2例,肿瘤完整切除20例,部分切除5例,未切除1例。并发症有出血3例、直肠损伤2例、术后骶前感染2例、脓肿形成1例。结论对于原发性骶前肿瘤均应手术完整切除肿瘤,合理选择手术径路是切除肿瘤的关键。

Objective To discuss the diagnosis and trentment of primary presacral tumors（PST）. Methods 26 patients with primary presacral tumors,who underwent surgical treatment from 1993 - 2005 were studied retrospectively. Result Clinical diagnosis was made mainly by routine digtal anal examination,ultrasound and CT scans. The operative ways included trans-sacrococcygeal position（ 12cases）, abdomen（Scases） and combinated the two ways （6cases）. Combination of tumor and rectum resection was performed in 2 patients. The tumor was completely resected in 20 cases, partially in 5 cases. Operative complications included haemorrhage （3 cases）, rectal injury （2cases）, infection（2cases） ,presacral abscess formation（lcases）. Conclusion Complete resection is the principal method in treating primary presacral tumor,whether the lesions are benign or malignant. Choice of operative way should be made according to tumor condition. It is important to aviod nerves and blood vessels from being injuried during operation.