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目的探讨原发性腹膜后肿瘤外科手术的最佳策略。方法回顾性分析1994年1月—2009年5月经手术治疗的原发性腹膜后肿瘤78例临床资料。结果恶性肿瘤38例,肿瘤最大径3~25 cm,平均9.94 cm;良性肿瘤40例,肿瘤最大径7~42 cm,平均18.36 cm。完整切除59例,姑息性切除15例,探查活检4例;完整切除组中联合脏器切除18例(30.51%),联合切除的器官依次为结肠、小肠、肾脏、胰腺和脾脏;血管重建3例。无围手术期死亡。恶性肿瘤完整切除者1,3,5年的生存率分别为88.04%,73.68%,42.10%,姑息性切除者1,3,5年的生存率分别为66.67%,33.33%,0,差异均具有统计学意义(均P<0.01)。术后复发再手术15例。结论完备的术前准备、恰当的手术入路和受累器官的联合切除是手术治疗腹膜后肿瘤的关键,复发后积极再手术仍可提高生存率。
Objective To explore the best strategy of primary retroperitoneal tumor surgery. Methods The clinical data of 78 patients with primary retroperitoneal tumor who underwent surgery from January 1994 to May 2009 were retrospectively analyzed. Results 38 cases of malignant tumors, the largest tumor diameter of 3 ~ 25 cm, an average of 9.94 cm; 40 cases of benign tumors, the largest tumor diameter of 7 ~ 42 cm, an average of 18.36 cm. Complete resection in 59 cases, palliative resection in 15 cases, exploration and biopsy in 4 cases; complete resection group in 18 cases (30.51%) resection of organs, combined resection of organs followed by colon, small intestine, kidney, pancreas and spleen; example. No perioperative deaths. The survival rates at 1, 3 and 5 years after complete resection of malignant tumor were 88.04%, 73.68% and 42.10% respectively. The survival rates of palliative resection at 1, 3 and 5 years were 66.67% and 33.33%, respectively With statistical significance (all P <0.01). Postoperative recurrence and operation in 15 cases. Conclusion The complete preoperative preparation, the appropriate surgical approach and the joint removal of the involved organs are the key to the surgical treatment of retroperitoneal tumor. After reoperation, the positive reoperation can still improve the survival rate.