原发性腹膜后肿瘤的临床诊治体会

Diagnosis and treatment of primary retroperitoneal tumor

目的探讨原发性腹膜后肿瘤的诊断和治疗方法。方法回顾性分析2003年1月至2011年7月我院收治的37例原发性腹膜后肿瘤手术患者的临床资料。结果 37例患者主要临床表现依次为腹部包块15例,腹痛腹胀12例,无症状体检发现7例,腰背部痛3例。术前B超和CT检查的诊断率分别为91.9%和97.1%。本组患者均行手术治疗,无围手术期死亡病例,术后病理良性肿瘤14例(37.8%),恶性肿瘤23例(62.2%)。肿瘤完整切除24例(64.9%),联合脏器切除5例(13.5%),姑息手术和探查活检8例(21.6%)。患者术后1年及3年生存率,良性肿瘤分别为100%和92.9%,恶性肿瘤分别为71.4%和52.4%。恶性肿瘤术后有5例复发。结论 CT是原发性腹膜后肿瘤最有效的检查方法,病理类型和肿瘤切除的完整性是影响预后的主要因素。

Objective To evaluate the diagnosis and treatment of the primary retroperitoneal tumors. Methods The clinical data of 37 cases with primary retroperitoneal tumors that were diagnosed and treated in our department from January 2003 to July 2011 were retrospectively analyzed and discussed. Results In major clinical situations of the 37 cases, 15 of the cases had abdominal mass, 12 had abdominal pain or fullness, 7 were asymptomatic,3 had waist or back pain. The accuracy rates of B ultrasound and CT were 91. 90% and 97. 1%, respectively. All the cases were treated with surgical operations withno perioperative deaths. Of 37 cases, 14 of cases were benign tumor（37.8 % ）, 23 were malignant tumor（ 62.2% ） ; 24 of cases （ 64.9% ） received complete resection, 5 cases （ 13.5 % ） received combined resection, 8 cases （21.6 % ） received palliative resection or exploratory biopsy. The 1- and 3 year survival rates in benign were 100% and 92.9% ,and in malignant were 71.4% and 52.4% ,respectively. 5 malignant cases had recurrence. Conclusion CT is the most effective method for the diagnosis;histopathology and complete excision are the critical factors to influence the prognosis of the primary retroperitoneal tumors.