原发性脾脏肿瘤的临床特点及外科治疗

Clinical Features and Surgical Treatment of Primary Splenic Tumors

目的探讨原发性脾脏肿瘤的临床特点及外科治疗。方法回顾性分析我院2002年1月至2012年6月收治的原发性脾脏肿瘤31例的临床资料。结果 31例患者中血管瘤14例,错构瘤5例,非何杰金氏淋巴瘤4例,表皮样囊肿5例,炎性假瘤2例,血管肉瘤1例。所有病例均行手术治疗,其中开腹脾切除术15例、脾部分切除术4例、腹腔镜脾切除术6例、腹腔镜脾囊肿开窗引流术5例、胰体尾并脾切除术1例。无围手术期死亡病例,良性患者术后长期存活,恶性患者手术后需接受综合治疗。结论脾脏原发性肿瘤临床少见,临床表现不典型,影像学检查是诊断脾脏肿瘤的主要方法。治疗首选手术,脾脏良性肿瘤手术效果较好,恶性肿瘤应在术后进行综合治疗,以提高生存率。

Objective To discuss the clinical features and surgical treatment of primary splenic tumors.Methods The clinical data of 31 patients with primary splenic tumors from January 2002 to June 2012 were analyzed retrospectively.Results All 31 cases included 14 cases of hemangioma,5 cases of hamartoma,4 cases of non-hodgkin＇s lymphoma,5 cases of epidermoid cyst,2 cases of inflammatory pseudotumor,and 1 case of haemangiosarcoma.All cases received the surgical treatment,including 15 cases of open splenectomy,4 cases of spleen partial splenectomy,6 cases of laparoscopic splenectomy,5 cases of laparoscopic splenic cyst drainage,and 1 case of pancreatic body and tail splenectomy.No perioperative death was found.The benign splenic tumor patients had a long-term postoperative survival;however,the malignant cases needed to receive combined modality therapy after operation to get a better prognosis.Conclusions Primary splenic tumor is rare in clinic,with atypical clinical manifestation.Imaging examination is the main method to diagnose splenic tumor.Surgery is the first choice of primary splenic tumor.The prognosis is better for benign splenic tumors;however,the malignant cases need to receive a com bined modality therapy after operation to get a better prognosis.