摘要
目的探讨经骶尾部横切口行骶前肿瘤切除的方法，总结其临床诊治体会；方法回顾性总结2003年1月-2012年i月手术治疗的56例骶前肿瘤患者的临床资料。均采用骶尾部横切口、离断骶尾关节进入骶前间隙，游离肿瘤两侧以及上下极，再游离并离断与盆腔脏器的紧密连接，切除肿瘤，术后放置负压引流。结果所有病例均完整切除肿瘤，术中出血平均110（30—200）ml，手术操作时间平均80（60～150）min，住院时间平均8（6—14）d，无盆腔脏器（直肠、膀胱、女性生殖器官等）损伤。术后恢复顺利，无切口感染，无明显骶前积液，均获得临床治愈；随访8年以上12例，5年以上18例，3年以上20例，1年以上6例，均未见复发。术后病理诊断：囊肿或上皮样囊肿21例，良性畸胎瘤19例，孤立性纤维性肿瘤4例，良性间质瘤3例，神经鞘瘤2例，副节瘤2例，淋巴管瘤2例，苗勒氏瘤1例，恶性畸胎瘤1例，恶性间质瘤1例。结论经骶尾部横切口切除骶前肿瘤是一种安全有效的手术入路和操作方法，值得进一步推广应用。
Objective To investigate the surgical method of presacral tumor with sacroiliac transverse incision, and to summarize the clinic experience of operative management. Methods The clinical data of 56 cases of primary presacral tumor admitted from January 2003 to January 2012 were analyzed retrospectively. All cases were received operation via sacroiliac transverse incision. The tumors were removed through presacral space. The managements of complicated disconnecting and massive hemorrhage were reviewed retrospectively. Results All 56 cases were completed the radical resection successfully without any accessory damage or serious complication. The intra-operative blood loss was 30 to 200 ml with an average of 110 ml, the operating time was 60 to 150 minutes with an average of 80 minutes, and the hospital stays was 6 to 14 days with an average of 8 days. All cases were followed up for 1 to 8 years without any recurrence sign. The postoperative pathologic result showed cyst or epithelial cyst in 21 cases, benign teratoma in 19 cases, solitary fibrous tumor in 4 cases, benign mesenchymal tumor in 3 cases, neurinoma in 2 cases, paraganglioma in 2 cases, lymphangioma in 2 cases, mullerian tumor in 1 case, malignant teratoma in 1 case and malignant interstitialoma in 1 case. Conclusion The radical excision via the approach of sacroiliac transverse incision is a safe and effective surgery for presacral tumor.
出处
《中国现代手术学杂志》
2014年第2期112-115,共4页
Chinese Journal of Modern Operative Surgery
关键词
骶前肿瘤
切口
presacral neoplasms
incision
