[Diagnosis and surgical therapy of primary retroperitoneal neurogenic tumors].

OBJECTIVE: To explore the diagnosis and surgical therapy for retroperitoneal neurogenic tumors (PRNTs). METHODS: The clinical records of 79 surgically treated patients with retroperitoneal neurogenic tumor were retrospectively analyzed. RESULTS: Twenty-nine patients presented with abdominal pain, 26 with abdominal mass, 15 with inferior extremities pain and numbness and 9 patients without clinical symptoms. Type B ultrasound (BUS), CT scan and surgical resection were performed for all the patients. Pathological analysis identified 19 patients with neurofibroma, 8 with neurilemmoma, 4 with paraganglioma, 21 with neurofibrosarcoma, 14 with malignant neurilemmoma, 6 with malignant paraganglioma, 5 with neuroectodermal tumor and 2 with neuroblastoma. The mortality rate of PRNT operation is was 1.3%, 3-year recurrence rate of benign tumor 0%, 5-year recurrence rate of benign tumor 12.9%, reoperation rate 100%, 5-year survival rate 100%. 3 years recurrence rate of malignancy tumor 41.6%, reoperation rate 90%, 5 years recurrence rate of malignancy tumor 79.1% and 5 years survival rate is 62.5%. CONCLUSION: BUS, CT and MRI are decisive for localization diagnosis. Surgical resection is the mainstay of therapy for this disease. Pre-operative preparation of intestinal tract and blood, maintaining the intactness of involved nerve are important for tumor resection. To prevent tumor recurrence, the key surgical techniques are to minimize tumor residues and . to handle intervertebral foramen properly.

[Surgery for extraperitoneal pelvic neoplasms].

OBJECTIVE: To evaluate the methods of surgery for extraperitoneal pelvic neoplasms. METHODS: Clinical data related to surgery of 84 cases of extraperitoneal pelvic neoplasms were extracted and retrospectively analyzed. RESULTS: All 84 patients underwent operations, including one of them who received 4 operations within 6 months for resection of a single tumor. 58 abdominal, 16 buttock and 10 combined incisions were made in the series. Pelvic organs and structures were co-resected in 35 cases, including total pelvic exenteration in 2 cases and anterior pelvic exenteration in 2 cases. Common and/or external iliac vessels were resected and transplantations of artificial vessel were carried in 5 cases. Internal iliac arteries were ligated in 10 cases. The mean blood lose was 2 385 ml in our series and the largest was 15 000 ml. The complete resection rate of tumor was 81% for 84 operations and the largest resected tumor was 30 cm x 30 cm x 25 cm. There was no hospitalized death, and postoperative complication rate was 7% (6/84) in our series. Only 1 death were seen during the mean period of postoperative follow-up of 54 months, 22 operations were carried for 21 cases of recurrence, including 7 operations for 7 recurrences in a case within 12 years. CONCLUSIONS: Making adequate abdominal or/and buttock incisions, exenterations of involved pelvic organs and structures, total pelvic exenteration if necessary, appropriate management of iliac vessels, planned re-operation for one tumor, and re-operation for recurrences are important methods for the treatment of extraperitoneal pelvic neoplasms.