摘要
目的 总结累及重要血管的腹膜后副神经节瘤的外科治疗经验.方法 收集华西医院血管外科2006年1月至2018年1月收治的累及大血管的腹膜后副神经节瘤21例患者的临床资料,对患者的生存状况、生存时间、临床病理特征及预后进行分析.结果 患者年龄为（49.5±11.2）岁.功能性肿瘤3例（14.3％）,均以高血压为首发症状;无功能性肿瘤18例（85.7％）,主要以腹部胀痛为首发症状.肿瘤直径为（12.5±4.7）cm,G1级肿瘤2例,G2级肿瘤14例,G3级肿瘤5例.21例患者均行肿瘤切除联合重要血管切除重建,其中15例达到R0切除,6例R1切除.围手术期无患者死亡,中位随访期5.6年（范围0.1～12年）,随访期内5例患者因肿瘤复发死亡,患者1,5,10年生存率分别为95％,89.4％及70.4％.结论 主要血管受累及不应是腹膜后副神经节瘤外科手术治疗的禁忌证,血管重建技术为这类患者提供了更多的肿瘤根治性切除机会.
Objective To analyze the prognosis of 21 cases of retroperitoneal paraganglioma with large vessels invaded in vascular surgery department of West China Hospital in recent 12 years. Methods The clinical data of 21 cases retroperitoneal paraganglioma with large vessels invaded were collected, and the clinic pathological features and prognostic factors were analyzed retrospectively. Results The average age of the patients was （49.5 ±11.2） years. Hypertension was the main symptom of all 3 functioning tumors （14.3%）. Abdominal distension pain was the primary symptom of the other 18 cases （85.7%） non-functioning tumors. The mean diameter of tumor was （12.5 ± 4.7） cm, with 2 cases of grade G1 tumor, 14 cases of grade G2 and 5 cases of grade G3, respectively. All the 21 patients underwent tumor resection combined with large vessels resection and reconstruction. 15 cases achieved R0 resection, 6 cases achieved R1 resection. No patient died during the perioperative period. The median follow-up period was 5.6 （0.1-12） years, with 5 patients died of tumor progress during the period, and the 1, 5,10 - year survival rate was 95.0%,89.4%,70.4%. Conclusions Large vessels invasion should not be a contraindication for surgical treatment of retroperitoneal paragangliomas, and vascular reconstruction provides more radical resection opportunities for these patients.
作者
杜晓炯
胡瀚魁
赵纪春
黄斌
袁丁
杨轶
曾国军
熊飞
Du Xiaojiong;Hu Hankui;Zhao Jichun;Huang Bin;Yuan Ding;Yang Yi;Zeng Guojun;Xiong Fei(Department of Vascular Surgery,West China Hospital of Siehuan University,Chengdu 610041,China)
出处
《中华血管外科杂志》
2018年第3期148-152,共5页
Chinese Journal of Vascular Surgery
关键词
副神经节瘤
外科切除
血管重建
预后
Paragangliomas
Surgical resection
Vessel reconstruction
Prognosis
