Objective To summarize the experience in diagnosis and treatment of primary retroperitoneal tumor (PRT). Methods Clinical data of 69 patients with PRT from June 1998 to June 2008 were analyzed retrospectively. Results Bellyache, abdominal distention, and abdominal mass were common symptoms in the patients with PRT. Ultrasound, CT, and MRI examination were effective. The major histopathological classification was soft tissue tumor, germinoma, lymphatic hematopoietic system tumors, and other rare tumors. Complete resection of tumors was performed in 42 cases, combined organs resection in 10 cases, partial resection of tumors in 11 cases, and only biopsy in 6 cases. There were 10 cases of intraoperative vessel and organ injury, which were treated by repair or vessels suturing and combined organ resection. Postoperative complications occurred in 8 cases, which were cured by conservative treatment. One patient died of hemorrhage acute stress ulcer combined multiple organ failure. The survival rates of 1, 3, and 5 years in patients underwent complete resection of tumors were 71%, 64%, and 46%, respectively. Of 11 patients underwent partial resection of tumors, 8 cases died within one year, and 3 cases died within 3 years after operation. All malignant tumor patients treated by biopsy died within one year after operation.Conclusion Synthetically using imaging examination may diagnose definitely, and to resect tumors as much as possible will improve patients’ survival.
目的 探讨经胆道镜联合钬激光碎石治疗肝内外胆管难取性结石的价值。方法 纤维胆道镜窥视下用钬激光碎石治疗肝内外胆管难取性结石29例,观察临床效果。结果 经1~3次胆道镜下钬激光碎石治疗,28例患者结石全部取尽,1例未完全取净,成功率为96.55%(28/29); 近期无胆道出血、漏胆、黄疸等并发症发生。26例获得随访,随访时间6~20个月,平均13个月,未发现结石复发及胆管狭窄。结论 经胆道镜钬激光碎石是一种治疗肝内外胆管难取性结石简便、安全及有效的方法。
目的比较腹腔镜阑尾切除术(LA)与传统开腹阑尾切除术(OA)在治疗老年(60岁)急性阑尾炎患者的临床疗效。方法回顾性分析2008年6月至2009年12月期间我院收治的67例老年急性阑尾炎患者的临床资料,根据接受的不同手术方式分为LA组(n=28)和OA组(n=39),对2组患者术中及术后相关指标进行比较。结果 LA组患者均顺利完成手术,无中转开腹; 术后无切口感染; 1例出现腹腔残余感染,经抗感染治疗后痊愈。OA组患者术后6例发生切口感染,经换药后痊愈; 5例发生腹腔残余感染,经抗感染治疗后痊愈。2组患者均无出血、阑尾残端漏、残株炎、粘连性肠梗阻等并发症发生。LA组患者手术时间与OA组比较差异无统计学意义(Pgt;0.05)。尽管LA组患者综合费用明显多于OA组(Plt;0.05),但术中出血量、术后下床时间、肛门排气时间、止痛剂使用率、切口感染率、腹腔残余感染率以及住院时间均小(少)于OA组(Plt;0.05)。 结论对老年急性阑尾炎患者的治疗,LA明显优于OA,且可作为老年急性阑尾炎患者治疗的首选术式。