邻近大血管的腹膜后肿瘤手术切除策略及技巧(附光盘)

Strategies and techniques for the resection of retroperitoneal tumors adjacent to large vessels

腹膜后肿瘤因位置隐蔽、体积较大、易压迫或浸润大血管和周围器官,术前需要对肿瘤进行准确评估,大血管的处理是这类手术成功的关键。选择开放手术还是腔镜手术尚无统一标准。开放手术虽然创伤大,但是在血管重建、器官修复方面明显优于腹腔镜。腹腔镜手术创伤小,与重要脏器或大血管粘连不紧密的囊性或体积较小的腹膜后肿瘤,以探查为目的腹腔镜切除手术切实可行。良好的手术效果依赖于术者对病例的准确分析及术者自身的临床经验。

Retroperitoneal tumors can easily compress or infiltrate large vessels and surrounding organs due to their concealed location and large volume. Accurate evaluation of the tumors is necessary before operation. The key element in the surgi- cal procedures is the management of the large vessels. There is no uniform standard for choosing open or endoscopic surgery. When the tumors invade large vessels, open surgery can be performed, such as vascular resection, repair, replacement and reconstruction of important organs. Laparoscopy is minimally invasive surgery. When cystic or small retroperitoneal tumors are not close to adhesive to important organs,laparoscopic resection is feasible. Good results depend on the surgeons＇ accurate analysis of the disease and their own clinical experience.