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目的:探讨不同手术方法在腹膜后肿瘤切除术中的应用。方法:回顾性分析2008~2015年收治的57例腹膜后肿瘤患者的临床表现、影像学诊断、手术方式、病理结果、术中情况及预后情况。结果:腹膜后肿瘤早期无特异性临床表现,早期肿瘤多为体检时发现。完整手术切除42例,腹腔镜手术切除26例,机器人辅助腹腔镜手术切除2例,开放性手术切除14例,未切除15例。腹腔镜手术中位手术时间105min,中位出血量90ml,术后中位住院天数7d;完全机器人辅助下手术2例,中位手术时间180min,中位出血量250ml,术后中位住院天数7d;开放性手术14例,中位手术时间180min,中位出血量600ml,术后中位住院天数9d。未手术患者15例,入院时已多发转移3例,1年内死亡6例,3年内死亡10例,手术患者42例,良性肿瘤37例,手术后至今未复发,恶性肿瘤5例,术后1年无死亡病例,术后3年死亡1例。结论:腹膜后肿瘤早期诊断早期手术切除能显著改善患者预后;腹腔镜手术,机器人辅助腹腔镜手术,开放性手术在切除腹膜后肿瘤时同样安全有效,但前两者在控制术中出血量,缩短手术时间及减少术后住院天数上更具优势。
Objective: To explore the application of different surgical methods in retroperitoneal tumor resection. Methods: The clinical manifestations, imaging diagnosis, operation methods, pathological findings, intraoperative status and prognosis of 57 patients with retroperitoneal tumors admitted from 2008 to 2015 were analyzed retrospectively. Results: Early retroperitoneal tumor without specific clinical manifestations, early detection of tumors were mostly found. Complete surgical resection in 42 cases, laparoscopic resection in 26 cases, robotic assisted laparoscopic resection in 2 cases, open surgery in 14 cases, not removed in 15 cases. The median operation time of laparoscopic surgery was 105 minutes, the median amount of bleeding was 90ml, and the median postoperative hospital stay was 7 days. Two cases under complete robot assisted operation, the median operative time was 180 minutes, the median amount of bleeding was 250ml, the median postoperative hospital stay was 7 days ; Open surgery in 14 cases, the median operation time 180min, the median amount of bleeding 600ml, the median postoperative hospital stay 9d. There were 15 cases of unoperated patients, 3 cases of multiple metastases on admission, 6 cases of death within 1 year, 10 cases of death within 3 years, 42 cases of surgery, 37 cases of benign tumors, no recurrence after operation, 5 cases of malignant tumors, No deaths in the year, 1 case died after 3 years. Conclusions: Early diagnosis of retroperitoneal tumor can significantly improve the prognosis of patients with early diagnosis. Laparoscopic surgery, robot-assisted laparoscopic surgery and open surgery are equally safe and effective in removing retroperitoneal tumor. However, Shorten the operation time and reduce the number of postoperative hospital days more advantages.