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目的探讨改良下腔静脉前入路法在腹膜后脂肪肉瘤根治切除手术中应用的安全性和可行性。方法回顾性分析北京大学肿瘤医院暨北京市肿瘤防治研究所软组织与腹膜后肿瘤中心2015年8月至2016年2月应用改良前入路法行肿瘤根治切除术治疗10例腹膜后巨大脂肪肉瘤病人的术中及术后资料。结果 10例病人均完整切除肿瘤。手术时间540~1000 min,术中出血800~6000 m L,联合右半肝切除2例,胰十二指肠切除术6例,右半结肠、右肾切除10例,下腔静脉切除重建5例。均达到R0切除,术后发生B级以上胰瘘1例,Clavien-DindoⅢ级以上腹腔感染2例,人工血管血栓形成1例,二次手术1例,无围手术期死亡。结论应用改良前入路法切除右侧腹膜后巨大脂肪肉瘤安全、可行,值得开展进一步研究。
Objective To investigate the safety and feasibility of modified inferior vena cava anterior approach in radical resection of liposarcoma of retroperitoneal. Methods A retrospective analysis was performed on 10 cases of retroperitoneal giant liposarcoma treated with radical neoplasm excision before the modified approach from August 2015 to February 2016 in Peking University Cancer Hospital and Beijing Institute of Oncology, Intraoperative and postoperative data. Results All the 10 patients had complete resection of the tumor. The operative time ranged from 540 to 1000 min, intraoperative bleeding ranged from 800 to 6000 m L, combined with right hemihepatectomy in 2, pancreatoduodenectomy in 6, right colon and right nephrectomy in 10, inferior vena cava resection and reconstruction 5 example. All of them achieved R0 resection. There were 1 case of pancreatic fistula above grade B, 2 cases of intraperitoneal infection of Clavien-Dindo grade Ⅲ or above, 1 case of artificial blood vessel thrombosis and 1 case of secondary surgery without perioperative death. Conclusion It is safe and feasible to use anterior approach to excise the right retroperitoneal giant liposarcoma and it is worth further study.