原发性腹膜后肿瘤75例手术治疗体会

Clinical experience in surgical treatment of primary retroperitoneal tumor (report of 75 cases)

目的总结原发性腹膜后肿瘤(PRT)手术治疗的经验。方法回顾性分析2000年1月至2011年12月期间,我院手术治疗75例PRT患者的临床资料。结果良性肿瘤26例,直径5cm～38cm,平均14.33cm,完整切除23例(88.46%);恶性肿瘤49例,直径4cm～22cm,平均8.50cm,完整切除38例(77.55%),两者在完整切除率上的差异无统计学意义。术后随访57例,良性肿瘤患者共有4例死于原发疾病及并发症,1、3、5年生存率为94.74%、84.21%、78.95%,恶性肿瘤1、3、5年生存率55.26%、23.68%、15.79%,两者差异有统计学意义(P<0.05),并且恶性PRT完整切除术后1、3、5年生存率显著高于部分切除术后生存率(P<0.05)。结论充分的术前准备,良好的手术路径与合适的切除方式,有利于手术的顺利实施与减少并发症的发生。肿瘤完整切除及根治性手术切除是治疗PRT的关键,有利于提高术后生存率。

Objective To summarize clinical experience in surgical treatment of primary retroperitoneal tumors （PRTs）. Methods Seventy-five cases of PRT diagnosed in our hospital from January 2000 to December 2011 were analyzed retrospectively. Results Among the patients, 26 cases were benign tumors （a diameter of 5-38cm and average of 14.33 cm） and 49 cases were malignant tumors （a diameter of 4-22 cm and average of 8.50 cm）. Twenty-three of benign tumors and 38 of malignant tumors were individually taken by complete excision. There was no statistical significance in complete excision rate between two groups of patients with benign and malignant tumors. Fifty-seven were followed up after surgical treatment,of which the 1-,3- and 5-year survival rate was 94.74%, 84.21% ,78.95% and 55.26%,23.68%,15.79% in benign and malignant cases respectively. All the differences between them had notable statistical significance. Moreover, when compared to palliative resection cases,the 1-,3- and 5-year survival rate in the complete excision cases with malignant PRT were significantly elevated, respectively. Conclusion Adequate preoperative preparation, right surgical approach and proper resection method are critical in treatment of PRTs. Tumor enbloc resection and radical resection would profit patients improvement in postoperative survival rate.