原发性腹膜后肿瘤诊断与外科治疗体会(附58例报告)

Diagnosis and surgical treatment of primary retroperitoneal tumor(a report of 58 cases)

目的探讨原发性腹膜后肿瘤诊断和外科治疗经验。方法回顾性分析本院2000年1月～2010年3月58例经手术治疗的原发性腹膜后肿瘤的临床资料。结果 58例中,临床症状主要表现为腹部肿块33例(56.9%),腹痛21例(36.2%),腹胀13例(22.4%);术后病理检查结果良性肿瘤19例,恶性肿瘤39例;肿瘤完整切除41例,姑息性切除16例,剖腹探查肿瘤活检术1例。58例患者围手术期无死亡,肿瘤完全切除组中位生存时间59个月,其l、3、5年生存率分别为88.2%、68.7%、35.8%;肿瘤姑息性切除组中位生存期35.3个月,其1、3、5年生存率分别为82.9%、53.8%、9.2%。结论手术切除是腹膜后肿瘤的最有效治疗方法,积极的外科治疗、争取完整切除可以延长患者的生存期,降低复发率。对于复发患者,应争取再次手术切除。

Objective To discuss the diagnosis and surgical treatment experiences of primary retroperitoneal tumor.Methods A retrospective analysis of clinical data was made in 58 cases with primary retroperitoneal tumor receiving surgical treatment in our hospital from January,2000 to March,2010.Results Among the 58 cases,the clinical symptoms were mainly abdominal mass in 33 cases（56.9%）,stomachache in 21 cases（36.2%）and abdominal distension in 13 cases（22.4%）.The postoperative pathological examination results showed benign tumor in 19 cases and malignant tumor in 39 cases.Forty one cases received the total resection of tumor;16 ones received palliative resection;one case received exploratory laparotomy for tumor biopsy.There was no death in the perioperative process.The median survival time of the patients receiving total resection of tumor was 59 months.Their 1,3 and 5-year survival rates were 88.2%,68.7% and 35.8%,respectively.The median survival time of the ones receiving palliative resection was 35.3 months.Their 1,3 and 5-year survival rates were 82.9%,53.8% and 9.2%,respectively.Conclusion Surgical resection is an effective therapeutic method for primary retroperitoneal tumor.Active surgical treatment and striving for total resection can prolong the patients＇ survival time and lower the recurrence rate.The patients with recurrence should receive the second surgical resection.