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目的探讨原发性腹膜后恶性肿瘤的外科治疗技巧。方法回顾性分析120例原发性腹膜后恶性肿瘤的临床资料,术前均行B超、CT或MRI检查,并行DSA 8例,IVP 28例;行肿瘤根治性切除88例,姑息性切除18例,未切除14例。结果全组无手术死亡,术后发生肺部感染11例,切口感染9例,腹腔感染6例,切口裂开5例,术后出血4例,肠梗阻3例,并发症发生率为31.7%(38/120)。88例肿瘤根治性切除者1、3和5年累积生存率分别为100.0%、91.2%和25.1%,姑息性肿瘤切除者1、3和5年累积生存率分别为34.1%、27.7%和7.2%,两组比较差异有显著性(P<0.05)。结论B超、CT、MRI和血管造影对判断肿瘤周围器官是否受累和切除范围有重要意义,外科手术切除肿瘤是提高原发性腹膜后恶性肿瘤生存率的最重要的手段,联合脏器切除能提高肿瘤的完整切除率,良好的手术技能是提高手术切除率的关键。
Objective To investigate the surgical treatment of primary retroperitoneal malignant tumors. Methods The clinical data of 120 patients with primary retroperitoneal malignancy were analyzed retrospectively. Preoperative ultrasound, CT or MRI were performed. DSA was performed in 8 cases and IVP in 28 cases. Tumor resection was performed in 88 cases and palliative resection Cases, not removed in 14 cases. Results There was no operative death in all the cases. There were 11 cases of lung infection, 9 cases of incisional infection, 6 cases of abdominal infection, 5 cases of incision, 4 cases of postoperative bleeding and 3 cases of intestinal obstruction. The incidence of complications was 31.7% (38/120). The 1, 3, and 5-year cumulative survival rates of 88 resected tumors were 100.0%, 91.2% and 25.1%, respectively. The 1,3 and 5-year cumulative survival rates were 34.1%, 27.7% and 7.2% %, There was significant difference between the two groups (P <0.05). Conclusions B-ultrasound, CT, MRI and angiography are important in determining whether the organs around the tumor are involved and the extent of resection. Surgical resection of the tumor is the most important means to improve the survival rate of primary retroperitoneal malignant tumors. Improve the complete tumor removal rate, good surgical skills is to improve the rate of surgical resection.