原发性腹膜后肿瘤76例诊治分析

黄建文; 胡晓勇; 谷宝军; 张炯; 张心如; 陈忠; 陈嵘; 宋鲁杰; 傅强

doi:10.13201/j.issn.1001-1420.2021.01.006

原发性腹膜后肿瘤76例诊治分析

- 1. 上海交通大学附属第六人民医院泌尿外科(上海, 200233);
- 2. 上海东方泌尿修复重建研究所
基金项目:
上海市第六人民医院院级科学研究基金（No：YNLC201816）

详细信息

通讯作者: 傅强,E-mail:jamesfu@aliyun.com

中图分类号: R735.4

收稿日期: 2020-05-21

Analysis of diagnosis and treatment of primary retroperitoneal tumor in 76 cases

- 1. Department of Urology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, 200233, China;
- 2. Shanghai Eastern Institute of Urologic Repair and Reconstruction

More Information

Corresponding author: FU Qiang, E-mail: jamesfu@aliyun.com

Received Date: 21 May 2020

摘要

摘要: 目的：探讨原发性腹膜后肿瘤（PRT）的诊治经验。方法：回顾性分析2014年1月—2019年12月我院收治的76例PRT患者的临床表现、影像学检查、手术方式、术中情况、术后病理及随访资料等。结果：PRT早期无特异性临床表现，多为体检时发现。手术切除60例，其中腹腔镜手术切除21例，开放性手术切除39例；未切除16例。开放手术组：肿瘤直径（14.1±6.4） cm，手术时间（175.2±31.5） min，术中出血量（823.5±125.6） mL，术后住院天数（10.5±2.8） d。腹腔镜组：肿瘤直径（7.4±3.1） cm，手术时间（133.8±27.8） min，术中出血量（245.6±87.7） mL，术后住院天数（6.7±1.9） d。两组肿瘤直径、手术时间、出血量和住院天数比较差异均有统计学意义（P<0.05）。病理诊断良性肿瘤29例（38.2%）；恶性肿瘤47例（61.8%），其中脂肪肉瘤22例（46.8%）。恶性PRT手术切除后接受化疗或放疗23例，未接受7例。平均随访时间57个月，随访72例，其中良性肿瘤28例，5年内复发1例，其他病例手术后至今无复发。恶性肿瘤44例，完整切除组的3年生存率为55.6%（10/18），姑息切除组为25.0%（3/12），未切除组为0（0/14）。局部复发、转移17例，再次手术治疗组3年生存率为36.4%（4/11），未接受再次手术组3年生存率为0（0/6），两组比较差异均有统计学意义（P<0.05）。术后接受放化疗组3年生存率为47.8%（11/23），未接受组为42.9%（3/7），两组比较差异无统计学意义（P>0.05）。结论：完整切除手术是PRT的首选治疗方式，腹腔镜手术在术中出血及术后恢复方面优于开放手术。恶性PRT术后复发率高，在多学科团队的指导下应积极再次手术治疗。
- 腹膜后肿瘤 /
- 腹腔镜手术 /
- 开放手术 /
- 手术治疗
Abstract: Objective: To analyze the experience in clinical diagnosis and treatment of primary retroperitoneal tumor(PRT).Methods: We retrospectively analyzed the clinical data of 76 patients diagnosed with PRT including general information, radiological studies, operation methods, intraoperative information, postoperative pathological and clinical follow-up data from Jan. 2014 to Dec. 2019.Results: In general, many patients of PRT were asymptomatic and mainly found through physical examination at the early stage. The tumors were resected in 60 patients, in which 21 patients were given laparoscopic surgery with diameter of tumors being(7.4±3.1) cm, operation time being(133.8±27.8) min, estimated blood loss being(245.6±87.7) mL and hospital stay being(6.7±1.9) days. Open surgery was performed on 39 patients with diameter of tumors being(14.1±6.4) cm, operation time being(175.2±31.5) min, estimated blood loss being(823.5±125.6) mL and hospital stay being(10.5±2.8) days. There was significant difference between laparoscopic surgery and open surgery. Sixteen patients were not given surgery. Twenty-nine cases were benign tumor(38.2%), and 47 cases were malignant tumor(61.8%), 22 cases of which were liposarcoma(46.8%). In malignant cases, 23 cases received chemotherapy or radiotherapy after surgical resection, but 7 cases did not receive these treatments. Median follow-up time was 57 months, and 72 cases were followed up. There were 28 patients of benign tumors and only one case has recurred. In 44 patients of malignant tumors, the 3-year survival rate of complete resection group was 55.6%(10/18), partial resection group was 25.0%(3/12) and no resection group was 0(0/14). In 17 cases of local recurrence or metastasis, the 3-year survival rate of cases given re-resection group(36.4%) was significant greater than that of no re-resection group(0). The 3-year survival rate of cases received chemotherapy or radiotherapy(47.8%) was similar to that of no chemotherapy or radiotherapy group(42.9%).Conclusion: Complete surgical resection is the preferred treatment of PRT. Laparoscopic surgery group performed better compared with open surgery group in the blood loss and postoperative recovery. The cases of malignant tumor are prone to relapse and re-resection should be actively given under the guidance of multiple disciplinary team.
- retroperitoneal tumor /
- laparoscopic surgery /
- open surgery /
- surgical treatment

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