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[腹膜后肿瘤与大血管手术]

[Retroperitoneal tumors and surgery of the great vessels].

作者信息

Barret A, Bossavy J P, Stouff S, Gouzi J L, Gedeon A

机构信息

Service de Chirurgie vasculaire, C.H.R. Toulouse Purpan, Toulouse.

出版信息

Chirurgie. 1997;122(1):25-30.

PMID:9183897
Abstract

The great vessels have long been considered as the limiting point for exeresis of abdominal tumors. We report eleven retroperitoneal tumors which led to more or less extensive vascular involvement. There were two benign tumors (neurofibroma, angiolymphoid tumor), 6 primary malignant tumors (liposarcoma, schwannosarcoma, corticoadrenal carcinoma, leiomyosarcoma of the inferior vena cava, leiomyosarcoma of the aorta, hemangiopericytoma) and 3 secondary malignant tumors (melanosarcoma, papillary cystadenocarcinoma, malignant germ cell tumor). Vascular surgery included mobilisation of the aorta or vena cava or total replacement with a prosthesis. There were no major complications and organ resection was limited to that required by tumor invasion. Despite a macroscopically satisfactory resection slice in all cases, local recurrence of malignant tumors was the rule leading to short term mortality (mean survival 30 months for primary sarcomas and 35 days for secondary forms). The therapeutic decision after careful CT and MRI word-up requires a discussion between the radiology, surgery and oncology teams. When the great vessels are involved, advice from a vascular surgeon should be acquired.

摘要

大血管长期以来一直被视为腹部肿瘤切除的限制点。我们报告了11例腹膜后肿瘤,这些肿瘤或多或少导致了广泛的血管受累。其中有2例良性肿瘤(神经纤维瘤、血管淋巴样肿瘤),6例原发性恶性肿瘤(脂肪肉瘤、神经鞘肉瘤、肾上腺皮质癌、下腔静脉平滑肌肉瘤、主动脉平滑肌肉瘤、血管外皮细胞瘤)和3例继发性恶性肿瘤(黑色素肉瘤、乳头状囊腺癌、恶性生殖细胞瘤)。血管手术包括主动脉或腔静脉的游离或用假体完全置换。无重大并发症,器官切除仅限于肿瘤侵犯所需的范围。尽管所有病例的切除切片在宏观上令人满意,但恶性肿瘤的局部复发是常见情况,导致短期死亡(原发性肉瘤的平均生存期为30个月,继发性肿瘤为35天)。在仔细的CT和MRI检查后做出治疗决策需要放射科、外科和肿瘤科团队之间进行讨论。当大血管受累时,应征求血管外科医生的意见。

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