中华泌尿外科杂志
中華泌尿外科雜誌
중화비뇨외과잡지
CHINESE JOURNAL OF UROLOGY
2013年
11期
836-838
,共3页
王刚成%韩广森%任莹坤%徐勇超%程勇%王有财
王剛成%韓廣森%任瑩坤%徐勇超%程勇%王有財
왕강성%한엄삼%임형곤%서용초%정용%왕유재
复杂盆腔肿瘤%联合脏器切除%膀胱
複雜盆腔腫瘤%聯閤髒器切除%膀胱
복잡분강종류%연합장기절제%방광
Complicated pelvic neoplasms%Multiorgan resection%Bladder
目的 探讨膀胱受侵的复杂盆腔肿瘤切除的手术入路方法. 方法 回顾性分析2007年10月至2010年10月12例膀胱受侵的复杂盆腔肿瘤患者资料.男8例,女4例.年龄35～65岁.肿瘤直径≥10 cm且＜16 cm者3例,≥16 cm者9例；肿瘤分期均为T4N0M0.手术均经膀胱入路,进入盆腔肿瘤下缘,并逆行向上将肿瘤与骶前、盆壁及盆腔脏器分离,完整切除盆腔肿瘤.总结12例患者围手术期及随访情况. 结果 12例手术时间110～150 min,中位时间126 min;术中出血量300～1200 ml,中位出血量521 ml；住院时间14～28 d,中位时间为22 d.围手术期患者无死亡.术后病理:胃肠间质瘤3例(属高危险度)、恶性畸胎瘤2例、恶性神经鞘瘤3例、子宫平滑肌肉瘤4例,手术切缘均为阴性.10例随访6～48个月.3例死于肿瘤复发、转移. 结论 经膀胱入路在复杂盆腔肿瘤切除术中的应用能有效提高肿瘤切除率,降低手术风险.
目的 探討膀胱受侵的複雜盆腔腫瘤切除的手術入路方法. 方法 迴顧性分析2007年10月至2010年10月12例膀胱受侵的複雜盆腔腫瘤患者資料.男8例,女4例.年齡35～65歲.腫瘤直徑≥10 cm且＜16 cm者3例,≥16 cm者9例；腫瘤分期均為T4N0M0.手術均經膀胱入路,進入盆腔腫瘤下緣,併逆行嚮上將腫瘤與骶前、盆壁及盆腔髒器分離,完整切除盆腔腫瘤.總結12例患者圍手術期及隨訪情況. 結果 12例手術時間110～150 min,中位時間126 min;術中齣血量300～1200 ml,中位齣血量521 ml；住院時間14～28 d,中位時間為22 d.圍手術期患者無死亡.術後病理:胃腸間質瘤3例(屬高危險度)、噁性畸胎瘤2例、噁性神經鞘瘤3例、子宮平滑肌肉瘤4例,手術切緣均為陰性.10例隨訪6～48箇月.3例死于腫瘤複髮、轉移. 結論 經膀胱入路在複雜盆腔腫瘤切除術中的應用能有效提高腫瘤切除率,降低手術風險.
목적 탐토방광수침적복잡분강종류절제적수술입로방법. 방법 회고성분석2007년10월지2010년10월12례방광수침적복잡분강종류환자자료.남8례,녀4례.년령35～65세.종류직경≥10 cm차＜16 cm자3례,≥16 cm자9례；종류분기균위T4N0M0.수술균경방광입로,진입분강종류하연,병역행향상장종류여저전、분벽급분강장기분리,완정절제분강종류.총결12례환자위수술기급수방정황. 결과 12례수술시간110～150 min,중위시간126 min;술중출혈량300～1200 ml,중위출혈량521 ml；주원시간14～28 d,중위시간위22 d.위수술기환자무사망.술후병리:위장간질류3례(속고위험도)、악성기태류2례、악성신경초류3례、자궁평활기육류4례,수술절연균위음성.10례수방6～48개월.3례사우종류복발、전이. 결론 경방광입로재복잡분강종류절제술중적응용능유효제고종류절제솔,강저수술풍험.
Objective To study the trans-bladder operative approach in resection of the complicated pelvic tumors with bladder invasion.Methods Twelve patients with complicated pelvic tumors were analyzed from Oct.2007 to Oct.2010.There were 8 males and 4 females.Patient's age was ranging from 35 to 65 years.There were 3 patients with tumor diameter from 10 to 16 cm and 9 patients with tumor diameter greater than 16 cm.All the tumors were located in the pelvic and the stage of all tumors was T4N0M0.The technology of trans-bladder to approach the lower edge of the pelvic tumor and then retrograde up to remove the tumor out of the presacral tissue,pelvic wall,and pelvic organ was applied.The length of hospital stay,operative time,blood loss,death during peri-operative period and the post-operative survival were analyzed retrospectively.Results The median operative time was 126 (110-150) min.The median blood loss was 521 (300-1200) ml.The median hospital stay was 22 (14-28) d.No patient died after surgery.Ten patients were followed up for 6 to 48 months.Three cases died of metastasis or recurrence.Conclusion With the trans-bladder operative approach,the resection of pelvic retroperitoneal tumors is effective and safe.
