原发性腹膜后肿瘤的诊断和治疗

Diagnosis and treatment of primary retroperitoneal tumor

作者医院自１９７８年至１９９６年１８年间共收治原发性腹膜后肿瘤９９例。其中良性４９例，恶性５０例，均经组织病理学证实。作者分析了腹膜后肿瘤在临床表现、病理类型和手术等方面的特点。良性腹膜后肿瘤病程长（３～４个月），肿瘤小（直径１２ｃｍ），症状轻，完整切除率高（８３．７％），很少合并脏器切除（１２．８％），术中平均失血少（平均６４０ｍｌ）；而恶性肿瘤病程短（１４．１个月），进展快，肿瘤较大（长径１７．５ｃｍ），完整切除率低（６０％），合并脏器切除率高（５９．５％），术中失血多（平均１５００ｍｌ）。Ｂ超检查有助于原发性腹膜后肿物的早期发现。手术完整切除是治疗的关键，术后放疗对防止复发，减轻症状有一定作用。

Abstract:Ninty-nine cases of primary retroperitoneal tumors (PRT), diagnosed and treated from 1978 to 1996 at Peking Union Medical College Hospital (PUMCH)were analysed. Tumors were benign in 49 cases and malignant in 50 cases, Clinical manifestation pathological classification and operative information were presented. In benign tumors, high complete excision rate (83.6%), rare resection of adjacent organs (12.5%)and less blood loss (640ml) were considered probably due to small size (12cm) and complete capsule. While in malignant, more blood loss (1500ml), low complete excision rate (60%) and high en bloc rate with adjacent organs (59.5%) were because of large size (17.5cm) of the tumors, fast growing and invading greater vessels. B-ultrasound could detect earlier lesions of PRT. Aggressive surgical excision might be optimal method to treat PRT. Post-operative radiotherapy seems to be worthwhile to prevent recurrence and alleviate symptom.