腹膜后肿瘤切除并重要血管重建86例分析

Retroperitioneal tumor resection complicated with invaded blood vessel reconstruction:an analysis of 86 cases

目的探讨累及重要血管的原发或复发性腹膜后肿瘤切除及受侵犯重要血管的处理方法,以提高肿瘤切除率。方法总结自1994年7月至2007年6月,86例累及重要血管的原发或复发性腹膜后肿瘤切除及血管重建的经验。结果获随访81例,随访时间1-157个月,平均6.8年。81例人工血管移植病人中,移植物血栓栓塞4例,其中1例左髂动脉移植术后8个月发生血栓栓塞延误就诊左下肢坏疽行左髂关节解脱。3例术后7-12个月髂静脉移植物血栓栓塞,肢体稍肿胀。生存期〉1年者74例,〉3年者61例,〉5年者39例,其余病例尚在随访中。随访中11例肿瘤复发再次切除。结论切除累及重要血管的原发或复发性腹膜后肿瘤并大血管重建,手术安全,可明显提高切除率,降低复发率,延长存活时间。

Objective To investigate the surgical methods of retroperitioneal tumor and major invaded blood vessel reconstruction. Methods The clinical data of 86 cases performed retroperitioneal tumor resection complicated with invaded blood vessel reconstruction between July 1994 and June 2007 were analyzed retrospectively. Results Among all the cases,81 cases were followed up with the period from 1 to 157 months （ mean 6.8 years）. Among 81 cases of prosthetic replacement,4 cases occurred prosthesis thromboembolism. One case of left arteria iliaca prosthesis occurred thromboembolism and left lower extremity occurred gangrene. The left articulatio coxae was disengaged. Three cases of vena iliaca prosthesis occurred thromboembolism in the postoperative 7 to 12 months, and the extremities swelled slightly. Seventy-four cases,61 cases and 39 cases were survived for more than 1 year,3 years and 5 years respectively. Eleven cases occurred tumor recurrence and be resected again during follow-up peroid. Conclusion It is safe for retroperitioneal tumor resection complicated with invaded blood vessel reconstruction ,which can improve resection effect, reduce recurrence rate and prolong the survival time.