腹膜后软组织肉瘤复发的再手术治疗:附25例报告
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曹晖E-mail:caohuishcn@hotmail.com

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Surgical treatment of recurrent retroperitoneal soft tissue sarcoma:report of 25 cases
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    摘要:

    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。

    Abstract:

    Objective:To explore the diagnosis and re-operation of the recurrent retroperitoneal soft tissue sarcoma (RPS).
    Methods:Clinical data of 25 patients with recurrent RPS were retrospectively analyzed.
    Results:All of 25 cases of recurrent RPS were diagnosed by operation and postoperative pathologic examination. They underwent a total of 42 time operations, with mean time of re-operations was 1.68. Of the 42 time operations, 26 time were complete resection, 11 time partial resection and 5 time only biopsy. A total of 19 cases underwent removal of contiguous intra-abdominal organs and 5 underwent resection of major invaded blood vessel. The 1-, 3-and 5-year survival rate of recurrent RPS was 52.0%, 40.0% and 28.0% respectively. The rate of complete resection in recurrent RPS with major blood vessel invasion was 35.7%. In contrast, the complete resection rate in recurrent RPS without major blood vessel invasion was 75%(P=0.013). On the other hand, there was no significant difference in complete resection rate between the recurrent RPS with adjacent organs invasion and the recurrent RPS with no adjacent organs invasion(P=0.462).
    Conclusions:Preoperative imaging results are crucial factor for assessment of operative resectability. Unless there are obvious comtraindications, recurrent RPS should undergo aggressive surgical excision.

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赵恩昊, 沈志勇, 曹晖, 吴志勇.腹膜后软组织肉瘤复发的再手术治疗:附25例报告[J].中国普通外科杂志,2009,18(12):1294-1297.
DOI:10.7659/j. issn.1005-6947.2009.12.018

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  • 收稿日期:2009-03-06
  • 最后修改日期:2009-11-07
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  • 在线发布日期: 2009-12-15