• 四川大學(xué)華西醫(yī)院肝膽胰外科（成都，610041）;

【摘要】　目的　 探討外科手術(shù)治療原發(fā)性腹膜后腫瘤的方法和影響患者預(yù)后的因素。　方法　 回顧分析2002年5月-2008年5月收治的70例原發(fā)性腹膜后腫瘤患者的臨床表現(xiàn)、影像學(xué)檢查、手術(shù)治療及隨訪情況。　結(jié)果　 70例患者均進行了手術(shù)治療，其中良性腫瘤20例（28.57%），惡性腫瘤50例（72.43%），良惡之比為1∶2.5；完整切除腫瘤者58例（82.86%），腫瘤部分切除者7例（10%），腫瘤廣泛轉(zhuǎn)移行組織活檢者5例（7.14%），聯(lián)合器官切除者18例（25.71%）。術(shù)后隨訪1~5年惡性腫瘤患者45例，其中腫瘤完全切除組1、3、5年的生存率分別為91.67%、66.67%、22.22%，腫瘤部分切除組分別為66.67%、33.33%、0%。兩組比較差異有統(tǒng)計學(xué)（P lt;0.01）。研究發(fā)現(xiàn)腫瘤的大小、病理類型、是否完整切除是影響腫瘤局部復(fù)發(fā)、患者生存率的重要因素。　結(jié)論　 早期診斷、充分的術(shù)前準備、腫瘤的全切除率能顯著改善患者術(shù)后遠期生存率。
【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.

引用本文： 汪景洲,黃紀偉,曾勇. 原發(fā)性腹膜后腫瘤的治療及預(yù)后分析. 華西醫(yī)學(xué), 2010, 25(11): 1952-1955. doi: 復(fù)制

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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. 　姜禮. 腹膜后腫瘤2例報告[J]. 中國普外基礎(chǔ)與臨床雜志, 2003, 10(4): 358.
4. 　李榮. 腹膜后腫瘤外科治療原則與策略[J]. 中國實用外科雜志, 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. 　田兆侖, 何東生, 王明才, 等. 原發(fā)性腹膜后腫瘤的手術(shù)徑路與方法[J]. 醫(yī)師進修雜志(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. 　歐陽曉暉, 孔廣忠. 原發(fā)性腹膜后腫瘤66例臨床分析[J]. 中國普通外科雜志, 1996, 5(6): 327-328.
10. 　陳凜, 李濤, 李榮, 等. 原發(fā)性腹膜后腫瘤600例臨床研究[J]. 中德臨床腫瘤學(xué)雜志(英文版), 2005, 4(4): 206-208.
  1. 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. 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. 3. 　姜禮. 腹膜后腫瘤2例報告[J]. 中國普外基礎(chǔ)與臨床雜志, 2003, 10(4): 358.
  4. 4. 　李榮. 腹膜后腫瘤外科治療原則與策略[J]. 中國實用外科雜志, 2008, 28(4): 246-248.
  5. 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. 6. 　田兆侖, 何東生, 王明才, 等. 原發(fā)性腹膜后腫瘤的手術(shù)徑路與方法[J]. 醫(yī)師進修雜志(外科版), 2005, 28(6): 21-23.
  7. 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. 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. 9. 　歐陽曉暉, 孔廣忠. 原發(fā)性腹膜后腫瘤66例臨床分析[J]. 中國普通外科雜志, 1996, 5(6): 327-328.
  10. 10. 　陳凜, 李濤, 李榮, 等. 原發(fā)性腹膜后腫瘤600例臨床研究[J]. 中德臨床腫瘤學(xué)雜志(英文版), 2005, 4(4): 206-208.