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目的总结原发性腹膜后肿瘤(PRT)的诊治体会。方法回顾性分析我科1998年6月至2008年6月间收治的69例PRT患者的临床资料。结果 PRT以腹痛、腹胀和腹部包块为主要症状,超声、CT、MRI等影像学检查可有效地检出。病理组织学分类主要分为软组织肿瘤、生殖细胞肿瘤、淋巴造血系统肿瘤和其他少见的肿瘤。69例患者中行肿瘤完全切除术42例,联合脏器切除术10例,肿瘤部分切除术11例,肿瘤不能切除仅行活检者6例。术中出现血管、脏器损伤10例,行修补或血管缝扎与联合脏器切除术。术后发生并发症8例,均经保守治疗后治愈。术后发生急性应激性溃疡出血合并多脏器功能衰竭死亡1例。肿瘤完整切除者术后1、3和5年生存率分别为71%、64%和46%。11例肿瘤部分切除术患者中8例于1年内死亡,3例于3年内死亡。恶性肿瘤不能切除仅行活检者均在术后1年内死亡。结论综合运用影像学检查能明确诊断;尽可能手术切除肿瘤,以提高患者生存率。
Objective To summarize the diagnosis and treatment of primary retroperitoneal tumor (PRT). Methods The clinical data of 69 patients with PRT admitted from June 1998 to June 2008 in our department were retrospectively analyzed. Results PRT was the main symptom of abdominal pain, abdominal distension and abdominal mass. Ultrasound, CT, MRI and other imaging examination can be effectively detected. Histopathological classification is divided into soft tissue tumors, germ cell tumors, lymphatic hematopoietic tumors and other rare tumors. Totally 69 patients underwent complete tumor resection in 42 cases, combined organ resection in 10 cases, partial tumor resection in 11 cases, the tumor could not be excised only in 6 cases. Intraoperative vascular, organ injury in 10 cases, line repair or vascular suture and joint resection. Postoperative complications occurred in 8 cases, were cured after conservative treatment. Postoperative acute stress ulcer bleeding combined with multiple organ failure in 1 case. The 1, 3, and 5-year survival rates of tumor resection were 71%, 64% and 46%, respectively. Eight of 11 patients undergoing partial tumor resection died within 1 year and 3 died within 3 years. Malignant tumors can not be removed only biopsy were killed within 1 year after surgery. Conclusion Comprehensive diagnosis can be confirmed by imaging examination. Surgical resection of the tumor is possible to improve the survival rate of patients.