【摘要】 目的 探讨外科手术治疗原发性腹膜后肿瘤的方法和影响患者预后的因素。 方法 回顾分析2002年5月-2008年5月收治的70例原发性腹膜后肿瘤患者的临床表现、影像学检查、手术治疗及随访情况。 结果 70例患者均进行了手术治疗,其中良性肿瘤20例(28.57%),恶性肿瘤50例(72.43%),良恶之比为1∶2.5;完整切除肿瘤者58例(82.86%),肿瘤部分切除者7例(10%),肿瘤广泛转移行组织活检者5例(7.14%),联合器官切除者18例(25.71%)。术后随访1~5年恶性肿瘤患者45例,其中肿瘤完全切除组1、3、5年的生存率分别为91.67%、66.67%、22.22%,肿瘤部分切除组分别为66.67%、33.33%、0%。两组比较差异有统计学(P lt;0.01)。研究发现肿瘤的大小、病理类型、是否完整切除是影响肿瘤局部复发、患者生存率的重要因素。 结论 早期诊断、充分的术前准备、肿瘤的全切除率能显著改善患者术后远期生存率。
【Abstract】 Objective To investigate the surgical management for primary retroperitoneal tumors (PRT) and the factors influencing the prognosis after operation. Methods The clinical manifestation, image data, treatment and prognosis of 70 patients with primary retroperitoneal tumor from May 2002 to May 2008 were retrospectively analyzed. Results All of the patients with PRT had undergone the operations, in whom 20 (28.57%) had benign tumors and 50 (72.43%) had malignant tumors with a ratio of 1:2.5. Among these patients, 58 (82.86%) had complete resection, 7 (10%) had incomplete resection, five (7.14%) had surgical biopsies and 18 (25.71%) had combined resection of the organs. A total of 45 patients with malignant tumors were followed up for one month to five years. The one-, three-, and five-year survival rates of the patients in complete resection group was 91.67%, 66.67% and 22.22%, respectively; and was 66.67%, 33.33%, and 0%, respectively in incomplete resection group. The differences between the two groups were significant (P lt;0.001). The results showed that the completeness of tumor, sizes, and histological type were associated closely with local recurrence and prognosis. Conclusion Early diagnosis, sufficient preoperative preparation and complete tumor resection play important roles in reducing the recurrence and improving the long-term survival rate.
Citation:
WANG Jingzhou,HUANG Jiwei,ZENG Yong. Treatment and Prognosis of Primary Retroperitoneal Tumor. West China Medical Journal, 2010, 25(11): 1952-1955. doi:
Copy
Copyright © the editorial department of West China Medical Journal of West China Medical Publisher. All rights reserved
1. |
Serio G, Tenchini P, Nifosi F, et al. Surgical strategy in primary retroperitoneal tumours [J]. Br J Surg, 1989, 76(4): 385-389.
|
2. |
Xu YH, Guo KJ, Guo RX, et al. Surgical management of 143 patients with adult primary retroperitoneal tumor[J]. World J Gastroenterol, 2007, 13(18): 2619-2621.
|
3. |
姜礼. 腹膜后肿瘤2例报告[J]. 中国普外基础与临床杂志, 2003, 10(4): 358.
|
4. |
李荣. 腹膜后肿瘤外科治疗原则与策略[J]. 中国实用外科杂志, 2008, 28(4): 246-248.
|
5. |
Pestieau SR, Jelinek JS, Chang D, et al. CT in the selection of patients with abdominal or pelvicsarcoma for reoperativesurgery [J]. J Am Coll Surg, 2000, 190(6): 700-710.
|
6. |
田兆仑, 何东生, 王明才, 等. 原发性腹膜后肿瘤的手术径路与方法[J]. 医师进修杂志(外科版), 2005, 28(6): 21-23.
|
7. |
Heslin MJ, Lewis JJ, Nadler E, et al. Prognostic factors associated with long-term survival for retroperitoneal sarcoma: implications for management[J]. J Clin Oncol, 1997, 15(8): 2832-2839.
|
8. |
Bautista N, Su W, O′Connell TX. Retroperitoneal soft-tissue sarcomas: prognosis and treatment of primary and recurrent disease[J]. Am Surg, 2000, 66(9): 832-836.
|
9. |
欧阳晓晖, 孔广忠. 原发性腹膜后肿瘤66例临床分析[J]. 中国普通外科杂志, 1996, 5(6): 327-328.
|
10. |
陈凛, 李涛, 李荣, 等. 原发性腹膜后肿瘤600例临床研究[J]. 中德临床肿瘤学杂志(英文版), 2005, 4(4): 206-208.
|
- 1. Serio G, Tenchini P, Nifosi F, et al. Surgical strategy in primary retroperitoneal tumours [J]. Br J Surg, 1989, 76(4): 385-389.
- 2. Xu YH, Guo KJ, Guo RX, et al. Surgical management of 143 patients with adult primary retroperitoneal tumor[J]. World J Gastroenterol, 2007, 13(18): 2619-2621.
- 3. 姜礼. 腹膜后肿瘤2例报告[J]. 中国普外基础与临床杂志, 2003, 10(4): 358.
- 4. 李荣. 腹膜后肿瘤外科治疗原则与策略[J]. 中国实用外科杂志, 2008, 28(4): 246-248.
- 5. Pestieau SR, Jelinek JS, Chang D, et al. CT in the selection of patients with abdominal or pelvicsarcoma for reoperativesurgery [J]. J Am Coll Surg, 2000, 190(6): 700-710.
- 6. 田兆仑, 何东生, 王明才, 等. 原发性腹膜后肿瘤的手术径路与方法[J]. 医师进修杂志(外科版), 2005, 28(6): 21-23.
- 7. Heslin MJ, Lewis JJ, Nadler E, et al. Prognostic factors associated with long-term survival for retroperitoneal sarcoma: implications for management[J]. J Clin Oncol, 1997, 15(8): 2832-2839.
- 8. Bautista N, Su W, O′Connell TX. Retroperitoneal soft-tissue sarcomas: prognosis and treatment of primary and recurrent disease[J]. Am Surg, 2000, 66(9): 832-836.
- 9. 欧阳晓晖, 孔广忠. 原发性腹膜后肿瘤66例临床分析[J]. 中国普通外科杂志, 1996, 5(6): 327-328.
- 10. 陈凛, 李涛, 李荣, 等. 原发性腹膜后肿瘤600例临床研究[J]. 中德临床肿瘤学杂志(英文版), 2005, 4(4): 206-208.
Journal type citation(8)
1. | 杨琨,费晨,王鹏飞,张斌飞,杨娜,田丁,庄岩,张堃. 自体或同种异体肌腱重建喙锁韧带与锁骨钩钢板治疗肩锁关节脱位效果的Meta分析. 中国组织工程研究. 2021(28): 4580-4586 . Baidu Scholar | |
2. | 林敏. 锁骨钩钢板固定与单纯同种异体肌腱重建喙锁韧带治疗肩锁关节脱位临床效果比较. 中外医学研究. 2021(04): 21-23 . Baidu Scholar | |
3. | 潘合科,罗德民,潘亚伟. 关节镜下自体和同种异体肌腱重建ACL治疗ACL损伤的效果研究. 深圳中西医结合杂志. 2020(08): 96-98 . Baidu Scholar | |
4. | 莫捷华,罗吉伟,吴志昌. 喙锁间线缆悬吊术与锁骨钩钢板治疗肩锁关节脱位疗效分析. 中国现代药物应用. 2020(13): 99-101 . Baidu Scholar | |
5. | 侯召猛,陈彦华,姜平. 同种异体肌腱结合克氏针治疗陈旧性肩锁关节脱位. 中国矫形外科杂志. 2019(08): 757-759 . Baidu Scholar | |
6. | 宋堃. 关节镜下TightRope绊钢板治疗肩锁关节脱位27例. 世界最新医学信息文摘. 2019(40): 50+52 . Baidu Scholar | |
7. | 王超然,张俊,陈鸿,赵道洪,张宇昊,吴志丹. 全关节镜下Twin Tail TightRope结合远端关节囊修复技术治疗急性肩锁关节脱位. 中国修复重建外科杂志. 2019(08): 970-975 . Baidu Scholar | |
8. | 赵梦楠,张义侠,刘妍,宋涛. 超声引导下注射治疗肱二头肌长头腱炎的疗效分析. 中国医科大学学报. 2018(08): 750-752 . Baidu Scholar | |
Other types of references(2)
1. | 冯俊铭. 探讨“筋骨并重”理论在手术治疗肩锁关节脱位的应用[D]. 广州中医药大学. 2022. Baidu Scholar | |
2. | 王晨. 喙锁韧带重建治疗肩锁关节脱位的生物力学实验和临床研究[D]. 西安医学院. 2019. Baidu Scholar | |