【摘要】 目的分析腹部巨大肿瘤的临床特点和治疗经验,为临床诊治提供参考。方法回顾性分析1998-12-01-2013-06-30莱州市中医院外科42例手术治疗腹部巨大肿瘤患者的临床资料。分析患者术后病理特点和生存情况,了解疾病发病特点及手术技巧对疾病风险和预后的重要性。结果42例患者均手术切除,完整或整块切除者30例(71.43%),联合脏器切除者9例(21.43%),姑息性切除者3例(7.14%)。肿块直径均>10cm,瘤质量1.0~8.5kg,平均5.7kg。患者均顺利康复出院,无围手术期死亡患者。术后病理诊断为恶性肿瘤31例(73.81%),良性肿瘤11例(26.19%);腹膜后肿瘤27例(64.29%),腹盆腔肿瘤15例(35.71%)。术后发生并发症9例(21.43%),其中切口感染3例(7.14%),肠梗阻7例(16.77%),尿潴留5例(11.90%),均经保守治疗后缓解。35例(83.33%)患者获得随访,中位随访时间35个月;6个月~3年内死亡5例,3~5年死亡6例。生存时间>5年者24例。完整切除患者>5年生存率为80.0%,与联合脏器切除患者57.14%差异无统计学意义(χ2=0.321,P>0.05),与姑息切除患者0差异有统计学意义,χ2=6.021,P<0.05。结论腹部肿瘤多数位于腹膜后,早期不易发现,易形成巨大肿瘤,一旦发现腹部巨大肿瘤,应争取尽早手术治疗;手术技巧是巨大肿瘤成功切除及减少术后并发症和提高生存率的关键。更多还原

【Abstract】 OBJECTIVE To investigate the clinical features and treatment experience of giant abdominal tumor,to provide reference for clinical diagnosis and treatment.METHODS The clinical data of 42 cases with giant abdominal tumor surgically treated from 1998-12-01 to 2013-06-30 in Department of Surgery of Laizhou Hospital of Traditional Chinese Medicine were retrospectively analyzed.Postoperative pathological characteristics and survival condition,as well as the importance of disease characteristics and surgical skills to the disease risk and prognosis were analyzed.RESULTSForty-two patients with giant abdominal tumor had achieved satisfactory effect after surgery and rehabilitation discharged from the hospital.Lump were all>10cm in diameter,and tumor mass was 1.0-8.5kg,with an average of 5.7kg.Thirty(71.43%)patients were treated with complete or en-block resection,nine(21.43%)patients treated with combined multivisceral resection surgery,three(7.14%)patients were treated with palliative resection surgery.Postoperative pathological diagnosis:malignant tumor 31(73.81%)cases,benign tumor 11(26.19%)cases;retroperitoneal tumor 27(64.29%)cases,abdominal pelvic tumor 15(35.71%)cases.There were 9(21.43%)cases with postoperative complications,infection of incision in 3cases(7.14%),intestinal obstruction in 7(16.77%)cases,urinary retention in 5cases(11.90%),they all relieved after conservative treatment.Totally 35(83.33%)patients were followed-up,the median follow-up time was35months;in 6months to 3years there were 5cases died,in 3-5years there were 6cases died.24 patients had survival time>5years.5year survival rate was 80.0%in complete resected patients,compared with that of multi-visceral resection patients(57.14%),there was no statistical difference(χ2= 0.321,P>0.05),compared with that of patients with palliative excision(0),difference was statistically significant(χ2=6.021,P<0.05).CONCLUSIONS Most abdominal tumors are located in the retroperitoneal,which are not easy to find early,and are easy to form a huge tumor.Surgical treatment should be taken as soon as possible when it is diagnosed.Surgical skills are important in reducing postoperative complications and improving survival.更多还原