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目的 总结经腹膜外和经腹腔切除原发性腹膜后肿瘤的优缺点 ,探讨最佳手术途径。方法回顾性分析原发性腹膜后肿瘤切除术 4 6例 ,其中经腹腔途径 (transabdominalapproach ,TAA)手术 2 6例 ,为TAA组 ,经腹膜外途径 (extraperitonealapproach ,EPA)手术 2 0例 ,为EPA组。 结果术后并发症发生率EPA组 (2 / 2 0 )比TAA组 (11/ 2 6 )低 (P <0 0 5 ) ,EPA组输血量 4 0 0 (QR∶70 0 )ml少于TAA组 80 0 (QR∶180 0 )ml(u =2 136 85 ,P <0 0 5 ) ,手术时间EPA组 (2 0 5± 6 0 )min短于TAA组(2 5 9± 110 )min(t=2 12 74 ,P <0 0 5 ) ,术后住院天数EPA组 (13± 4 )d少于TAA组 (18± 8)d(t =2 95 33,P <0 0 1) ,差异均有显著意义。结论EPA是原发性腹膜后肿瘤简便安全的手术途径。
Objective To summarize the advantages and disadvantages of extraperitoneal and transabdominal resection of primary retroperitoneal tumor and to explore the best surgical approach. Methods A total of 46 patients with primary retroperitoneal resection were retrospectively analyzed. Twenty-six patients undergoing transabdominalapproach (TAA) surgery were TAA. Twenty patients underwent extraperitonealapproach (EPA) group. Results The incidence of postoperative complications was lower in the EPA group (2/2 0) than in the TAA group (11/2 6) (P 0 05) In the group of 80 0 (QR:180 0) ml (u = 2 136 85, P 0 05), the time of operation in the EPA group was shorter than that of the TAA group (25 59 ± 110) min t = 2 12 74, P 0 05). The postoperative days of hospitalization in the EPA group (13 ± 4) d were less than those in the TAA group (18 ± 8) d (t = 2 95 33, P 0 01) All have significant meaning. Conclusion EPA is a simple and safe surgical approach to primary retroperitoneal tumor.