AIM： To analyze the surgical management of adult primary retroperitoneal tumors （APRT） and the factors influencing the outcome after operation. METHODS： Data of 143 cases of APRT from 1990 to 2003 in the First Aff...AIM： To analyze the surgical management of adult primary retroperitoneal tumors （APRT） and the factors influencing the outcome after operation. METHODS： Data of 143 cases of APRT from 1990 to 2003 in the First Affiliated Hospital of China Hedical University were evaluated retrospectively. RESULTS： A total of 143 cases of APRT were treated surgically. Among them, 122 （85.3%） underwent complete resection, 16 （11.2%） incomplete resection, and 3 （3%） surgical biopsies. Twenty-nine （20.2%） underwent tumor resection plus multiple organ resections. Ninety-five malignant cases were followed up for 1 mo to 5 years. The 1-year, 3-year, and 5-year survival rates of the patients subject to complete resection was 94.9%, 76.6% and 34.3% and that of patients with incomplete resection was 80.4%, 6.7%, and 0%, respectively （P 〈 0.001）. The Cox multi-various regression analysis showed the completeness of tumor, sex and histological type were associated closely with local recurrence. CONCLUSION： Sufficient preoperative preparation and complete tumor resection play important roles in redudng recurrence and improving survival.展开更多
文摘目的探讨超声引导竖脊肌平面阻滞(erector spinae plane block,ESPB)对泌尿外科后腹膜外腔镜手术的镇痛效果及术后康复的影响。方法纳入择期行泌尿外科单侧后腹膜外腔镜手术的患者62例,采用随机数字表法分为两组(每组31例):竖脊肌平面阻滞组(E组)和对照组(F组)。两组于全身麻醉诱导前行超声引导下ESPB,E组给予0.375%罗哌卡因+右美托咪定0.5μg/kg混合液共30 ml,F组给予0.9%氯化钠注射液30 ml。两组均采用全身麻醉,术毕进入PACU,术后两组均行患者自控静脉镇痛(patient⁃controlled intravenous analgesia,PCIA)。记录两组患者麻醉前(I1)、手术切皮时(I2)、分离肾周(I3)、术毕(I4)的心率及MAP;记录两组患者术中瑞芬太尼用量、PACU舒芬太尼用量及术后24 h内PCIA舒芬太尼用量;记录两组患者术后3、6、9、12、24 h VAS疼痛评分及舒适度评分(Bruggrmann Comfort Scale,BCS);记录两组患者术后24 h PCIA有效按压次数(D1)和实际按压次数(D2),计算D1/D2。记录两组患者术后康复指标(术后住院时间、肛门排气恢复时间、引流管拔除时间、尿管拔除时间、首次下床活动时间)及术后恶心、呕吐、穿刺损伤等不良反应发生情况。结果E组I2、I3时心率及MAP低于F组(P<0.05),术中瑞芬太尼用量、PACU舒芬太尼用量、术后24 h PCIA舒芬太尼用量低于F组(P<0.05),D1/D2高于F组(P<0.05),术后3、6、9、12、24 h VAS疼痛评分低于F组,BCS高于F组(P<0.05),术后住院时间、肛门排气恢复时间、引流管拔除时间、尿管拔除时间、首次下床活动时间短于F组(P<0.05)。两组患者术后恶心、呕吐发生率比较差异无统计学意义(P>0.05),两组均未出现穿刺损伤。结论超声引导ESPB应用于泌尿外科后腹膜外腔镜手术安全、有效,增强了术后镇痛效果,加快了患者的恢复,符合加速康复外科理念。
文摘AIM： To analyze the surgical management of adult primary retroperitoneal tumors （APRT） and the factors influencing the outcome after operation. METHODS： Data of 143 cases of APRT from 1990 to 2003 in the First Affiliated Hospital of China Hedical University were evaluated retrospectively. RESULTS： A total of 143 cases of APRT were treated surgically. Among them, 122 （85.3%） underwent complete resection, 16 （11.2%） incomplete resection, and 3 （3%） surgical biopsies. Twenty-nine （20.2%） underwent tumor resection plus multiple organ resections. Ninety-five malignant cases were followed up for 1 mo to 5 years. The 1-year, 3-year, and 5-year survival rates of the patients subject to complete resection was 94.9%, 76.6% and 34.3% and that of patients with incomplete resection was 80.4%, 6.7%, and 0%, respectively （P 〈 0.001）. The Cox multi-various regression analysis showed the completeness of tumor, sex and histological type were associated closely with local recurrence. CONCLUSION： Sufficient preoperative preparation and complete tumor resection play important roles in redudng recurrence and improving survival.
