Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Hepato-Pancreato-Biliary Surgery, Peking University Cancer Hospital and Institute, Beijing, China (mainland).
Med Sci Monit. 2018 Feb 16;24:961-969. doi: 10.12659/msm.908559.
BACKGROUND There is no standard surgical approach for the management of retroperitoneal sarcoma. The aim of this clinical study was to describe the experience of an anterior approach to en bloc resection in left-sided retroperitoneal sarcoma with adjacent organ involvement. MATERIAL AND METHODS This retrospective clinical study included 25 patients who were diagnosed with left-sided retroperitoneal sarcoma and underwent tumor resection at a single center between May 2012 and July 2017. All patients had tumors that were adjacent to the left colon, pancreas, left kidney, left adrenal gland, and psoas major; some of the tumors were adjacent to the diaphragm, stomach, and small intestine. An anterior approach was used to remove the left-sided retroperitoneal tumor with the adhesive organs en bloc, an approach that is described in detail. The value of this surgical approach was evaluated based on the histopathological findings, postoperative complications, and patient follow-up. RESULTS The median number of resected organs, in addition to the retroperitoneal tumor, was 8 (range, 6-10). Complete macroscopic tumor resection was achieved in 23 cases (92%). Twenty-four patients (96%) had tumor infiltration of at least one organ or the surrounding fat. Three patients (12%) experienced Grade III and IV postoperative morbidities. The one-year disease-free survival rate was 91.3% among patients with macroscopically complete resections. The one-year overall survival rate was 83.2%. CONCLUSIONS In selected patients, left-sided retroperitoneal sarcoma associated with local organ involvement can be surgically managed using an anterior approach with en bloc resection of adjacent organs.
对于腹膜后肉瘤的治疗，目前尚无标准的手术方法。本临床研究的目的是描述采用前入路整块切除伴邻近器官受累的左侧腹膜后肉瘤的经验。
本回顾性临床研究纳入了 2012 年 5 月至 2017 年 7 月期间在单一中心接受肿瘤切除术的 25 例左侧腹膜后肉瘤患者。所有患者的肿瘤均与左结肠、胰腺、左肾、左肾上腺和腰大肌相邻，部分肿瘤与膈肌、胃和小肠相邻。采用前入路整块切除左侧腹膜后肿瘤及其粘连器官，详细描述了这种手术方法。根据组织病理学发现、术后并发症和患者随访评估该手术方法的价值。
除腹膜后肿瘤外，中位数切除器官数为 8 个（范围 6-10 个）。23 例（92%）患者实现了完全的宏观肿瘤切除。24 例（96%）患者的肿瘤至少浸润了一个器官或周围脂肪。3 例（12%）患者发生 3 级和 4 级术后并发症。行宏观完全切除的患者 1 年无病生存率为 91.3%。1 年总生存率为 83.2%。
在选择合适的患者中，对于伴有局部器官受累的左侧腹膜后肉瘤，可采用前入路整块切除邻近器官的方法进行手术治疗。
