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目的探讨复发性腹膜后软组织肉瘤的诊断和再手术治疗。方法回顾性分析收治的手术后复发并再次手术的25例复发性腹膜后软组织肉瘤的临床资料。结果25例复发性腹膜后软组织肉瘤均经手术及病理证实,因多次复发(1~5次,平均1.68次/例),共行手术42次,包括完整切除26次,部分切除11次,探查活检5次。手术中联合脏器切除共19例,合并大血管切除共5例。末次术后1,3,5年生存率分别是52.0%,40.0%,28.0%。累及重要血管的肿瘤的完整切除率(35.7%)比未累及重要血管(75.0%)者明显降低(P=0.013),而肿瘤是否累及临近脏器对手术完整切除率没有影响(P=0.462)。结论影像学检查对术前评估和手术切除范围有重要意义。对于复发性腹膜后软组织肉瘤,只要无明显手术禁忌,就应积极予以手术切除。
Objective To investigate the diagnosis and reoperation of recurrent retroperitoneal soft tissue sarcoma. Methods The clinical data of 25 patients with recurrent retroperitoneal soft tissue sarcoma who underwent recurrence and reoperation after operation were analyzed retrospectively. Results Recurrence of retroperitoneal soft tissue sarcoma in 25 cases was confirmed by operation and pathology. Because of multiple recurrences (1 ~ 5 times, average 1.68 times / case), 42 cases underwent total resection including 26 complete resections and 11 partial resections, Biopsy 5 times. A total of 19 cases of surgical resection of the organ combined with major vascular resection in 5 cases. The 1, 3, 5-year survival rates after the last surgery were 52.0%, 40.0% and 28.0%, respectively. The complete resection rate (35.7%) was significantly lower in patients with major vascular involvement (75.0%) than in those without major vascular involvement (P = 0.013). However, the presence or absence of tumor adjacent organs had no effect on the complete resection rate (P = 0.462) . Conclusion The imaging examination is of great significance to the preoperative evaluation and surgical resection scope. For recurrent retroperitoneal soft tissue sarcoma, as long as no obvious taboo surgery, they should be actively removed.