成人骶前肿瘤的外科诊治体会(附10例报告)

Surgical Treatment of Adult Presacral Tumor (Report of 10 Cases)

摘要: 目的：探讨成人骶前肿瘤的手术入路及技巧。方法：回顾性分析2009年至2011年之间诊治的10例成人骶前肿瘤患者资料，并结合文献分析。结果：10例肿瘤均获完整切除，5例经骶尾部切除，4例经腹入路切除，1例经腹膜外入路切除。无围手术期死亡，无排便异常、大出血等并发症。经随访2~4年，术后仅1例粘液性脂肪肉瘤患者局部复发。结论：对骶3平面以下、直肠指捡可触及肿瘤1半以上者可经骶尾部切除，位置较高、肿瘤较大者宜行经腹入路。术前准备及术中手术技巧对于获得满意的手术效果具有重要意义。 To explore surgical approaches and skills about adult anterior sacral tumor. Methods: 10 adult sacral tumor patients during 2009-2011 had been retrospectively analyzed, combined with literature study. Results: All of the cases accepted complete resection, 5 by sacrococcygeal approach, 4 by transabdominal approach, 1 by extra-peritoneal approach. There is no complication like perioperative mortality or abnormal defecation and bleeding. Only one mucinous liposarcoma recurrence has been detected during a 2 - 4 years follow up. Conclusion: tumors below 3th sacral plane especially more than half of which could be reached by digital rectal examination are suitable for the sacrococcygeal approach. Those higher and larger are adapting the abdominal approach. Preoperational preparation and operative skills are also of great importance to obtain satisfactory therapeutic result.