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腹膜后脂肪肉瘤联合胰腺切除15例临床分析

钱红纲李成鹏吴剑挥,丘    辉,郝纯毅   

  1. 恶性肿瘤发病机制及转化研究教育部重点实验室 北京大学肿瘤医院暨北京市肿瘤防治研究所软组织与腹膜后肿瘤中心,北京100142
  • 出版日期:2017-12-01 发布日期:2017-11-30

  • Online:2017-12-01 Published:2017-11-30

摘要:

目的    探讨腹膜后脂肪肉瘤联合胰腺切除的可行性和安全性。方法    回顾性分析2014年10月至2016年10月北京大学肿瘤医院软组织与腹膜后肿瘤中心收治的15例行联合胰腺切除的腹膜后脂肪肉瘤病人的临床资料,其中8例病人联合胰十二指肠切除,7例病人联合胰体尾及脾切除。随访15(3~27)个月,观察术后疗效。结果    15例病人均顺利完成手术。手术时间为420(240~1020) min,术中出血1200(200~6000)mL。术后病理学检查示,7例病人肿瘤侵犯了胰腺实质,6例肿瘤侵犯了胰腺被膜。15例病人均联合结肠部分切除,6例联合血管切除和替代,10例联合一侧肾及肾上腺切除,其余5例既往手术已切除肾脏,6例行膈肌部分切除及修补,2例联合肝脏切除。术后8例病人发生胰瘘,其中A级5例,B级3例;Clavien-Dindo分级Ⅲa级并发症3例、Ⅴ级1例(术后3个月死亡)。结论    联合胰腺切除在腹膜后脂肪肉瘤手术中安全可行,为一种可选择的术式。

关键词: 腹膜后肿瘤, 脂肪肉瘤, 胰腺切除, 手术安全性

Abstract:

Combined resection of pancreas for retroperitoneal liposarcoma:A report of 15 cases        QIAN Hong-gang,LI Cheng-peng,WU Jian-hui,et al. Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education),Soft Tissue and Retroperitoneal Tumor Center, Peking University Cancer Hospital & Institute,Beijing 100142,China
Corresponding author:HAO Chun-yi,E-mail:haochunyi@vip.sina.com
Abstract    Objective    To investigate the feasibilities and safeties of pancreas resection for the surgical treatment of retroperitoneal liposarcoma. Methods    A total of 15 cases of retroperitoneal liposarcoma performed with pancreas resection at Soft Tissue and Retroperitoneal Tumor Center, Peking University Cancer Hospital & Institute between October 2014 and October 2016 were analyzed retrospectively. The cases included 8 cases of pancreaticoduodenectomy and 7 cases of distal pancreatectomy with splenectomy. Results    All tumors were resected completely. Operations lasted for 420(240-1020) min. The blood loss was 1200(200-6000)mL. The pathology showed the parenchyma of pancreas were invaded in 7 cases,and only the capsula of pancreas were invaded in 6 cases. Partial colectomy were performed in all 15 patients,combined with 6 large vessels resection and replacement,10 right nephrectomy and adrenalectomy,6 diaphragm partial resection and repair,2 hepatectomy. Five cases were observed with ISGPF Grade A pancreatic fistula and 3 cases were Grade B. Three cases were with complication of Clavien-Dindo IIIa. And 1 died 3 months post operation. Conclusion    Combined resection of pancreas is feasible,safe and could be an option for resection of retroperitoneal liposarcoma.

Key words: retroperitoneal tumor, liposarcoma, pancreatectomy, safety of operation