目的

探讨腹膜后副神经节瘤的临床诊治方法及手术疗效。

方法

回顾性分析2015 年4 月至2024 年1 月北京大学国际医院收治的42 例腹膜后副神经节瘤的临床资料，探讨其临床特点、手术疗效及预后。

结果

42 例腹膜后副神经节瘤术前有儿茶酚胺功能性肿瘤19 例，无明显症状15 例，8 例伴腹胀腹痛、腰背部疼痛等。40 例为单发肿瘤，2 例为多发肿瘤，术中22 例血压波动明显，手术R0或R1 切除共38 例，R2 切除4 例，联合脏器切除6 例，肿瘤中位最大径7 cm（3～27）cm，术中出血量为800 ml（50～4500）ml，术后并发症7 例。术中血压波动组与血压平稳组相比，肿瘤体积更大、出血量多、术后住院时间延长，差异均有统计学意义（P＜0.05），随访3～68 个月，2 例患者复发，1 例出现远处转移。

结论

手术是腹膜后副神经节瘤主要的治疗方法，术中血压波动增加手术风险，术前精确的评估及充分的术前准备有助于降低手术风险。

Objective

To explore the clinical diagnosis, treatment, and surgical efficacy for retroperitoneal paraganglioma.

Methods

The clinical data of 42 cases of retroperitoneal paraganglioma admitted to Peking University International Hospital from April 2015 to January 2024 were retrospectively analyzed, and their clinical characteristics, surgical efficacy, and prognosis were discussed.

Results

Of the 42 patients with retroperitoneal paraganglioma, 19 had functional catecholamine-secreting tumors before surgery, 15 had no obvious symptoms, and 8 had abdominal distension, abdominal pain, and back pain.Forty cases had a single tumor, and two had multiple tumors.Twenty-two cases had obvious fluctuation in blood pressure during operation.Thirty-eight cases achieved R0 or R1 excision, and four achieved R2 resection.Six cases underwent combined organ resection.The median maximum tumor diameter was 7 (range, 3～27) cm.Intraoperative blood loss was 800 (range, 50～4500) ml.There were 7 cases of postoperative complications.Compared with patients with stable blood pressure, those with intraoperative blood pressure fluctuation had significantly larger tumor size, more bleeding, and prolonged postoperative hospital stay (P＜0.05).After 3～68 months of follow-up, two patients had recurrence and one had distant metastasis.

Conclusion

Surgery is the main treatment method for retroperitoneal paraganglioma.Intraoperative blood pressure fluctuation increases the risk of surgery.Accurate preoperative assessment and adequate preoperative preparation can help reduce the risk of surgery.