原发性腹膜后肿瘤手术若干技巧及相关问题探讨

Several surgical skills and the discussion to the question of primary retroperitoneal tumor.

目的探讨原发性腹膜后肿瘤的手术方法及注意事项，以提高手术切除率，降低手术风险。方法回顾性分析我院2004年1月至2008年12月50例经外科手术治疗的原发性腹膜后肿瘤的临床资料。结果50例中良性20例，恶性30例。完整切除39例（78％），其中合并脏器切除10倒（20％）；大部切除3例（6％），无法切除只做活检8例（16％）。本组手术切除率为84％（42／50）。结论充分的术前准备及术中视野开阔，层次清晰，是切除腹膜后肿瘤的基本条件，相应的手术技巧可降低手术风险。原则上应作肿瘤完整切除．肿瘤累及脏器应酌情联合切除，完整切除是目前最有效的治疗方法，也是降低术后复发的主要措施。

Objective To investigate the strategy and announcements of surgery in primary retroperitoneal tumor for improving the rescetable rate and decreasing the surgical risk. Methods Clinical data of 50 cases undergoing surgery of retroperitoneal tumor in our hospital from January 2004 to December 2008 were retrospectively analyzed. Results Tumors were benign in 20 cases and malignant in 30 cases. Complete resection was achieved in 39 cases（78% ） ,in which combined organ resection carried out in 10 cases（20% ） ,3 cases（6% ） underwent partial resection, non-resection and had biopsy only were performed in 8 cases （ 16% ）, so the rescetable rate of this clinical were 84% （42/50）. Conclusions Abundant preoperative preparation, wide open operation field and distinct anatomical dissection were the essential condition of the resecting primary retroperitoneal tumor. The relevant surgical skill should decrease the surgical risk. The tumor should be completely reseeted in principle, and invaded neighboring organs should be resected with the discretion at the same time. Completely resected was the key to improving the survival rate and the strategy to decreasing the recurence rate for recurrent retroperitoneal tumor.