原发性腹膜后肿瘤切除时主要血管的重建

Reconstruction of major blood vessels when performing resection of retroperitoneal neoplasm.

目的 探讨累及主要血管的原发性腹膜后肿瘤切除时 ,主要血管的处理方法 ,以提高切除率。方法 总结 4 5例累及主要血管原发性腹膜后肿瘤的切除及血管重建的经验。结果 无手术死亡。随访 4 1例 ,随访时间3～ 87个月 ,平均 4 9个月 ,移植物血栓栓塞 2例 ,其中 1例左髂动脉移植物术后 8个月发生血栓栓塞延误就诊左下肢坏疽行左髋关节解脱。术后 7个月髂静脉移植物血栓栓塞 1例 ,肢体稍肿胀。生存期 >1年者 36例 ,生存期 >3年 33例 ,>5年 6例 ,其余病例尚在随访中。随访过程中 5例肿瘤复发再次切除。结论 对累及主要血管原发性腹膜后肿瘤切除合并大血管重建手术安全 ,可明显提高手术切除率降低复发率 ,延长存活时间。

Objective To study the surgical manipulation of major blood vessels invaded by retroperitoneal tumors in order to raise the resection rate. Methods Review the experience of resection for retroperitioneal tumors along with the reconstruction of major blood vessels in 45 patients in multiple hospital from July 1994 to August 2001.Results This group had no surgical mortality after following-up 3 months to 87 months (average 49 months) in 41 patients.The grafts occlusion occurred in 2 cases.Survival time was more than 1 year in 36 cases,three years in 33 cases,five years in 6 cases.Conclusion Combined resection of retroperitoneal neoplasm and reconstruction of major blood vessels is safe,effective and practical.It can increase the excision rate and decrease the recurrence rate,and prolong survival time.