الملخص
Objective:To identify the risk factors for functional delayed gastric emptying(FDGE)after retroperitoneal tumor resection.Meth-ods:Sixty-seven patients with postoperative FDGE after retroperitoneal tumor resection from September 2017 to December 2022 admited in Peking University International Hospital were included in the observation group,and 836 normal patients who underwent ret-roperitoneal tumor resection during the same period were included in the control group.Medical histories and clinical treatment data were obtained for each group and compared to identify the risk factors for FDGE after retroperitoneal tumor resection.Results:The overall incid-ence of postoperative FDGE was 7.42%.Factors that were significantly elevated(P<0.05)in the observation group relative to the control group included adverse mental factors(37.31%),preoperative digestive tract obstruction(41.79%),postoperative abdominal cavity complic-ations(79.10%),diabetes(29.86%),average age of(61.85±6.11)years,and blood loss(1 011.94±507.30)mL.Pre-and post-surgery albumin levels[(38.22±3.75)g/L and(30.22±3.36)g/L,respectively]were significantly reduced(P<0.05)in the observation group compared to the control group.Risk factor analyses revealed that advanced age,diabetes,preoperative digestive tract obstruction,intraoperative blood loss,perioperative albumin level,postoperative abdominal cavity complications,and adverse mental factors were correlated with postoperative FDGE.Conclusions:Diverse factors could impact the risk of FDGE after retroperitoneal tumor resection.Patients should be accurately evalu-ated;reasonable and detailed prevention and treatment plans should be developed.
الملخص
Objective:To summarize the experience of surgical treatment of pelvic retroperitoneal neoplasms.Methods:A total of 107 patients with pelvic retroperitoneal neoplasms underwent surgical treatment from Apr 2015 to Sep 2020. According to the neoplasm location, size, and the relationship with the surrounding tissues, individualize the surgical plan, analyze the patient's basic condition, bleeding volume, tumor size, whether it is the first operation,or combined organ resection, etc.to find out the relevant factors affecting the surgical complications.Results:The surgical route included anterior approach in 67 cases , sacrococcygeal approach in 21 cases, combined abdominal-sacral approach in 13 cases, and laparoscopy in 5 cases. Twenty-nine patients underwent combined organ resection, postoperative complications occurred in 27 patients including colorectal anastomotic leakage in 6 cases, urinary fistula in 6 cases, delayed pelvic floor healing in 6 cases, rectovaginal fistula in 3 cases, and postoperative bleeding in 2 cases. The statistical analysis show whether or not first operation is related to the occurrence of complications ( χ2=4.79, P<0.05) Conclusion:Pelvic retroperitoneal neoplasms need to be fully prepared before surgery and individualized design. Intraoperative combined bleeding control measures and combined organ resection can effectively increase the resection rate and ensure the safety of surgery.
الملخص
Objective:To investigate the pathogeny, diagnosis and treatment of solitary fibrous tumors of the abdomen and pelvis.Methods:Retrospective analysis was made on the clinical data of 12 SFT patients undergoing surgical resection in Peking University International Hospital from Jul 2015 to Jul 2019.Results:All patients underwent radical resection. After operation, complications in clued pelvic hemorrhage in 1 case and ureteral fistula in 1 case, all improved after conservative treatment.According to pathological and immunohistochemical results, 7 cases were MSFT and 5 cases were SFT. All patients were followed up for 2-53 months. 5 cases were recurrent, among which 1 case died of intestinal obstruction caused by tumor compression.Conclusion:The clinical manifestations of solitary fibrous tumors are mostly nonspecific.Imaging examination and puncture pathology are of great significance for preoperative diagnosis. Radical resection is an important means to improve the prognosis of patients.
الملخص
Objective To provide evidence for the application of nutritional intervention strategy by analyzing perioperative nutritional status of retroperitoneal liposarcoma patients.Methods 60retroperitoneal liposarcoma patients were divided into primary group (27 cases) and relapse group (33cases).These patients were put on nutritional risk evaluation using nutritional risk screening (2002)(NRS2002) within 24 hours of admission,and the serum albumin (ALB) value was recorded.Results Preoperative NRS2002 score showed that relapse group had a higher chance of cacotrophy.Serum albumin level from different time point showed that patients in relapse group were more prone to cacotrophy (respectively t =9.174,4.720,10.950,8.772,10.960,all P ＜ 0.05) and subject to slower recovery of gastrointestinal function [(86 ± 15) h vs.(61 ± 6) h] (t =7.903,P ＜ 0.05),prolonged antibiotic use [(15.5 ± 5.6) d vs.(7.3 ± 0.7) d],t =7.55,P ＜ 0.05),the average length of hospital stay was longer [(25.5±6.0) d vs.(14.1 ± 1.7)d] (t =9.571,P＜0.05),and higher inhospita cost [(13.2±5.6) × 104 yuan vs.(6.8 ± 0.9) × 104 yuan] (t =5.871,P ＜ 0.05).Though there was no difference between the two groups in incision complication rates (x2 =2.625,P ＞ 0.05)Conclusions Retroperitoneal liposarcoma patients has perioperative nutritional risk.Compared with the primary group,patients from relapse group have higher chance to got cacotrophy.NRS2002 scoring system is simple,it could be used in predicting nutritional risk for those patients.