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原发性腹膜后肿瘤仍以手术切除为主要治疗手段.然而,由于腹膜后间隙较大,肿瘤往往生长到较大才出现症状而确诊.巨大的肿瘤可使腹腔与腹膜后的解剖位置面貌全非,而且恶性度高,浸润范围广,一旦累及相邻脏器或包绕大血管时,常给手术带来严重困难.本文结合1967～1990年本院收治的61例原发性腹膜后肿瘤,就其手术处理和经验教训进行讨论.认为原则上应作肿瘤全切除,如浸润范围不太大,肿瘤又尚未固定,可将肿瘤与受累脏器一并切除.不能完整切除的可作包膜内肿瘤切除.对无完整包膜且浸润亦深的高度恶性的腹膜后肿瘤,原则上应作整块切除加淋巴结清扫,如已广泛浸润固定不能整块切除,可做肿瘤部分切除或活检,了解病理类型,以利术后进行化疗和放疗。对术后复发者,争取再次或多次手术.
Primary retroperitoneal tumors are still treated with surgical resection as the main treatment. However, due to the large retroperitoneal space, the tumors often grow to a relatively large size before they are diagnosed. The large tumors can make the anatomical position of the abdominal cavity and retroperitoneum Non-, but high degree of malignancy, infiltration of a wide range, once involving adjacent organs or wrapping large blood vessels, often bring serious difficulties to surgery. This article combined 61 cases of primary retroperitoneal tumors treated in our hospital from 1967 to 1990 , Discuss the surgical treatment and lessons learned. In principle, the tumor should be completely removed. If the infiltration range is not too large, the tumor has not been fixed yet. The tumor and the affected organ can be removed together. Intramembrane tumor resection. In the case of highly malignant retroperitoneal tumors with intact capsules and deep infiltrates, in principle, a total resection plus lymphadenectomy should be performed. If extensive infiltration has been performed, a complete resection may not be performed and a partial resection or biopsy of the tumor may be performed. To understand the pathological type, in order to facilitate chemotherapy and radiotherapy after surgery. For recurrence after surgery, try again or more surgery.