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目的探讨右上腹肿瘤联合脏器切除的手术入路及手术技巧的安全性和可行性。方法回顾2004年1月至2012年2月期间,郑州大学附属肿瘤医院普外科收治的21例右上腹肿瘤行联合脏器切除病人的临床资料。采用右下腹膜后逆行入路或(和)肝被膜下入路,分析术中出血量、手术时间及术后并发症情况。结果本组21例病人均行右上腹肿瘤联合脏器切除术,采用右下腹膜后逆行入路的病人17例,采用肝被膜下入路联合右下腹膜后逆行入路的病人4例,平均出血量为350mL,平均手术时间105min,其中18例术后恢复顺利,1例出现胰瘘,1例出现胆瘘,1例出现粘连性肠梗阻,经通畅引流及营养支持治疗后均痊愈出院,无一例死亡。结论右上腹肿瘤联合脏器切除采用右下腹膜后逆行入路和(或)肝被膜下入路是安全、可行的。
Objective To investigate the safety and feasibility of surgical approaches and surgical techniques in the treatment of right upper quadrant tumors combined with organ resection. Methods From January 2004 to February 2012, the clinical data of 21 patients with right upper quadrant tumors underwent combined organ resection were collected from General Surgery Affiliated Tumor Hospital, Zhengzhou University. The right lower retroperitoneal retrograde approach or (and) hepatic capsule approach was used to analyze intraoperative blood loss, operative time and postoperative complications. Results The group of 21 patients underwent right upper quadrant tumor combined with organ resection, 17 patients underwent right lower retroperitoneal retrograde approach and 4 patients underwent retrograde hepatic subarachnoid retrograde retrograde approach. The mean Bleeding amount was 350mL, the average operation time was 105min, of which 18 cases recovered smoothly, one case of pancreatic fistula, one case of biliary fistula, one case of adhesive intestinal obstruction, drainage and nutritional support after treatment were cured and discharged, No one died. Conclusion It is safe and feasible to use the right lower retroperitoneal retrograde approach and / or subretinal approach in the right upper quadrant tumor combined with organ resection.