Li Wen-Xiang, Tong Han-Xing, Lv Chen-Tao, Yang Hua, Zhao Gang, Lu Wei-Qi, Zhang Yong
Department of General Surgery, Shanghai Public Health Clinical Center, Fudan University, Shanghai 200083, China.
Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
World J Clin Cases. 2022 Jan 21;10(3):811-819. doi: 10.12998/wjcc.v10.i3.811.
Management of retroperitoneal sarcoma (RPS) involving the iliac artery is challenging and requires the concerted efforts of multidisciplinary team (MDT) members during surgical treatment.
To summarize the clinicopathologic features of RPS involving the iliac artery and our retroperitoneal soft tissue tumor MDT surgical experience.
In this retrospective study, 15 patients with RPS involving the iliac artery who underwent surgery at our retroperitoneal soft tissue tumor center from July 2004 to June 2020 were analyzed. Statistical analyses were performed by Student's -test with SPSS 16.0.
Complete tumor resection (R0/R1) and iliac artery reconstruction were achieved in all 15 patients. All the operations were successful, with no serious complications or perioperative death. Resection with bilateral iliac artery reconstruction required a higher intraoperative blood transfusion volume than resection with unilateral iliac artery reconstruction. Recurrent cases were more likely to bleed and required a higher blood transfusion volume than primary cases. As of January 2021, 11 patients were alive, and 4 had died. Local recurrence occurred in two patients, one of whom developed liver metastasis.
Resection of RPS involving iliac vessels is feasible and effective when performed by MDT members. Iliac artery oncovascular resection and reconstruction are key to a successful operation. Adequate blood preparation is important for successful completion of surgery.
涉及髂动脉的腹膜后肉瘤(RPS)的管理具有挑战性,在手术治疗期间需要多学科团队(MDT)成员的共同努力。
总结涉及髂动脉的RPS的临床病理特征以及我们腹膜后软组织肿瘤MDT的手术经验。
在这项回顾性研究中,分析了2004年7月至2020年6月在我们腹膜后软组织肿瘤中心接受手术的15例涉及髂动脉的RPS患者。使用SPSS 16.0进行Student's检验进行统计分析。
所有15例患者均实现了肿瘤完全切除(R0/R1)和髂动脉重建。所有手术均成功,无严重并发症或围手术期死亡。双侧髂动脉重建切除术的术中输血量高于单侧髂动脉重建切除术。复发病例比原发病例更容易出血,且需要更高的输血量。截至2021年1月,11例患者存活,4例死亡。2例患者发生局部复发,其中1例发生肝转移。
MDT成员进行涉及髂血管的RPS切除是可行且有效的。髂动脉肿瘤血管切除和重建是手术成功的关键。充足的血液准备对于手术的成功完成很重要。