原发性腹膜后肿瘤114例手术治疗分析.DOCVIP

临床医学论文-原发性腹膜后肿瘤114例手术治疗分析 ????????? 作者：彭森　李军尧　唐忠志　程青　陈谦????? 【摘要】? 　　目的 总结原发性腹膜后肿瘤（PRPT）的临床特征、诊断及治疗经验、教训。方法 对我院114例经手术和病理证实的原发性腹膜后肿瘤的临床表现、辅助检查、病理类型及外科治疗等临床资料进行回顾分析。结果 首发症状及体征多数为腹痛及腹部包块。B超及CT的诊断率分别为91．6%，94．2%。其中良性肿瘤44例，占38．6%，恶性肿瘤70例，占61．4%。本组良性肿瘤切除率95．5%，恶性肿瘤切除率85．7%。术后良性肿瘤复发4例，行根治术；恶性肿瘤复发31例，26例行根治术，5例行部分切除术。结论 B超、CT等影像学检查是诊断PRPT的重要手段。完整切除肿瘤是治疗PRPT的关键和影响其预后的重要因素。对侵犯脏器者应采用将累及脏器一并切除，不能切除和切除后再发者宜探查活检和再次手术切除。 【关键词】? 原发性腹膜后肿瘤；诊断；治疗 　　Surgical Treatment Analysis on 114 Cases of Primary Retroperitoneal Tumor 　　Abstract： Objective? To investigate the clinical characteristics, diagnosis and surgical treatment of primary retroperitoneal tumor (PRPT). Methods? The clinical data of 114 patients with PRPT that validated by operation and pathology were retrospectively analyzed, including clinical manifestation, radiological inspection, pathologic examination and surgical procedure. Results?The first symptom and sign were always bellyache and belly tumor. Diagnosed rates by B style ultrasonic and computerized tomography (CT) were 91.6% and 94.2%, respectively. There were 44 cases of benign tumor and 70 cases of malignant tumor in all the cases. Resection rate of benign tumor was 95.5%, and that of malignant tumor was 85.7%. Four cases of recurrent benign PRPT underwent complete resection, as well as 26 cases of recurrent malignant PRPT. Five cases of recurrent malignant PRPT underwent partial resection.Conclusion?Radiological examination is crucial for the diagnosis of PRPT. Complete resection is the key to its treatment. The total resection of other implicated organs is the best way to the treatment. The patients with recurrent PRPT can be treated with reoperation plus biopsy. 　　Key? words： primary retroperitoneal tumor; diagnosis; therapy ??? 原发性腹膜后肿瘤(primary retroperitoneal tumor，PRPT)是指源于腹膜后的脂肪、神经、淋巴、结缔组织、尿生殖源性、生殖细胞源性等组织的肿瘤，而不包括后腹膜脏器如胰腺、肾、肾上腺及大血管的肿瘤，发病率占全身肿瘤的0．3%~2．0%。由于早期大多数无特殊的临床症状而不易被发现，患者就诊时多因病变广泛致手术无法彻底切除，治疗较为困难。我院从1996年1月—2006年12月，共手术治疗原发性腹膜后肿瘤114例，取得了一定的经验，现报告如下。