恶性肿瘤术后腹壁种植转移的病因分析和防治措施

Analysis of Pathogenesis,Prevention and Treatment of Implantation Metastases of Abdominal Wall

目的 探讨恶性肿瘤腹壁种植转移的病因、预防和治疗。方法 对 7例腹壁种植转移瘤的临床资料进行回顾性分析。结果 本组病例在操作中均未采取有效的预防种植的措施。 2例活检未切除 ,其余 5例肿瘤切除并辅以放疗和 或化疗。 1例局部复发再手术后 34个月死亡 ,2例均活检后 1个月死亡 ,其余 4例随访 3～ 2 7个月存活。结论 肿瘤细胞的脱落及腹壁未采取有效保护措施是造成腹壁种植转移的主要原因。应避免肿瘤细胞与切口的直接接触。腹壁种植转移瘤的处理应根据腹腔内转移及全身情况来决定。

Objective To investigate the pathogenesis,prevention and treatment of implantation metastases of abdominal wall.Methods 7 patients with implantation metastases of abdominal wall were analyzed retrospectively.Results There was no effective prevention measure to be taken in operative procedure for all patients.2 patients were taken simple biopsies and 5 were treated by operations combined with radiotherapy and/or chemotherapy.1 patient with tumor recurrence died 34 months after reoperation,2 died 1 month after biopsies,and 4 were followed up for 3 to 27 months and were still alive.Conclusion Exfoliatation of tumor cells and lack of effective wound protection are the main causes of implantation metastasis of abdominal wall.It is very important to avoid direct contact between tumor cells and wound.The treatment of the complication depends on whether or not have intra abdominal metastasis and systemic failure.