在治疗恶性非器官性腹膜后肿瘤方面,联合外科干预(包括血管外科干预)的领域

O. I. Kit, A. A. Maslov, E. Kolesnikov, O. V. Katelnitskaya, M. A. Kozhushko, A. V. Snezhko, T. B. Katsieva, R. E. Myagkov, S. V. Sanamyants, A. E. Anisimov, K. V. Kolomiets
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摘要

研究目的分析局部晚期恶性非器官性腹膜后肿瘤(NRT)手术治疗后的近期疗效。国立肿瘤医学研究中心腹部肿瘤科№1对114名恶性腹膜后肿瘤患者进行了手术治疗,其中男性48人,女性66人。根据组织学结构,64 例(56.1%)患者通常被检测出脂肪肉瘤。术中复查发现,有 67 例(58.8%)肿瘤扩散到邻近的解剖结构。109例患者进行了切除手术干预,其中106例(97.2%)患者的手术量为R0。62例(54.4%)患者接受了非器官性肿瘤的联合手术治疗,其中45例(72.6%)患者接受了多器官手术治疗。12例患者进行了下腔静脉切除术。2 名患者切除了肠系膜上静脉,2 名患者切除了髂结肠静脉。1例患者切除了左肾静脉,并缝合了血管壁外侧缺损。有 14 名患者(12.3%)在手术期间和术后早期出现并发症。共有2名患者在术后死亡,死亡率为1.8%。肿瘤侵犯大血管并非局部扩散的恶性非器官性腹膜后肿瘤手术治疗的禁忌症。
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Area of combined surgical interventions, including those with an angiosurgical component, in terms of malignant non-organ retroperitoneal tumors’ treatment
Purpose of the study. To analyze the immediate outcomes following surgical treatment of locally advanced malignant non-organ retroperitoneal tumors (NRT).Materials and methods. Surgical interventions for malignant NRTs were performed in 114 patients at Abdominal Oncology Department № 1, National Medical Research Centre for Oncology.There were 48 males and 66 females among them. According to the histological structure, liposarcoma was commonly detected in 64 (56.1 %) cases.Results. Intraoperative revision revealed the spread of the tumor to adjacent anatomical structures in 67 (58.8 %) cases. Resection surgical interventions were performed in 109 patients, of which 106 (97.2 %) patients had operations performed in an amount of R0. Combined surgical interventions for NRTs were performed in 62 (54.4 %) patients, and multiorgan happened to be in 45 (72.6 %) patients out of those. Resection of the inferior vena cava was performed in 12 patients. Resection of the superior mesenteric vein was performed in 2 patients and the iliac-colonic vein in 2 patients. In 1 observation the left renal vein was resected with suturing of the lateral defect of the vessel wall. Complications during surgery and in the early postoperative period were noted in 14 (12.3 %) patients. In total, 2 patients died after operations, the mortality rate was 1.8 %.Conclusions. Tumor invasion of big main blood vessels is not a contraindication for surgical treatment of locally spread malignant non-organ retroperitoneal tumors.
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