姑息手术治疗的5例复发性腹膜后脂肪肉瘤病例报告及文献回顾

A case report and literature review of 5 cases of recurrent retroperitoneal liposarcoma treated by palliative surgery

目的分析姑息手术治疗的复发性腹膜后脂肪肉瘤患者的临床资料,进行文献回顾并总结临床诊疗经验。方法收集厦门大学附属翔安医院5例复发性腹膜后脂肪肉瘤并接受姑息手术的患者资料,其中女3例,男2例,年龄43~66岁,平均53.8岁,查体均发现腹部包块,计算机断层扫描检查考虑为巨大脂肪肉瘤。同时记录手术情况及随访信息。结果5例患者均接受姑息切除,手术时间295~677min,中位394min;术中出血量600~8000ml,中位出血量1300ml术中输血量480~2220ml,中位1140ml;术后住院时间20~81d,中位住院时间32.5d;术后病理报告为去分化脂肪肉瘤。术后1例死亡,4例症状缓解,生活质量改善。截至末次随访,4例患者病情稳定未见进展。结论对于腹膜后脂肪肉瘤,即使在多次复发后肿瘤不能被完全切除,仍应考虑姑息性切除。虽然姑息性手术在提高生存率方面存在争议,但它可以极大地改善患者的生活质量。姑息手术应在充分考虑术后并发症对生存率的影响并在多学科腹膜后肉瘤专家团队讨论后谨慎进行。

Objective To analyze clinical data of patients with recurrent retroperitoneal liposarco-ma treated with palliative surgery,and summarize diagnosis and treatment experiences.Methods Data from 5 patients(3 females and 2 males,aged 43-66,average 53.8)at Xiang'an Hospital were collected,including surgery and follow-up information.Results All underwent palliative resection.Operation time was 295-677 min(median:394).Blood loss was 600-8000 ml(median:1300 ml).Blood transfusion was 480-2220 ml(median:1140 ml).Hospital stay was 20-81 days(median:32.5).One patient died post-surgery,and 4 had improved quality of life.At last follow-up,4 had stable disease.Conclusion Palliative resection for recurrent retroperitoneal liposarcoma can improve quality of life despite controversial survival benefits.Surgery should be cautiously considered with a multidisciplinary expert team.