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腹膜后肿瘤出现症状就诊时,肿瘤通常发展的比较大且多已累及重要血管。腹膜后肿瘤所累及重要血管外科处理的关键是提高肿瘤切除率。首先应用CT、MRI及数字减影血管造影等影像学方法判断腹膜后肿瘤所累及重要血管的情况。良好显露为控制和处理血管出血创造了必要条件,增加了手术安全性。血管阻断前应行局部或全身肝素化,有些重要的血管需行修复和重建。自体血管的使用已日渐成熟,人工血管和补片的使用为手术提供了便利。重建时要注意恢复血管功能及防止血管损伤和术后血栓形成。
When symptoms appear in retroperitoneal tumors, tumors usually develop larger and often involve important blood vessels. The key to vascular surgery involved in retroperitoneal tumors is to increase the rate of tumor resection. First of all, CT, MRI and digital subtraction angiography and other imaging methods to determine the importance of retroperitoneal tumor involving the blood vessels. Good exposure creates the necessary conditions for controlling and managing vascular hemorrhage, increasing surgical safety. Localized or systemic heparinization should be performed before vascular occlusion, and some important blood vessels should be repaired and reconstructed. The use of autologous blood vessels has become more mature, the use of artificial blood vessels and patches to facilitate the operation. Reconstruction should pay attention to restore vascular function and prevent vascular injury and postoperative thrombosis.