Introduction and Objectives
The aim of this study was to present our experience in managing retroperitoneal tumors knowing that these special tumors represent a big challenge for many surgeons.
Material and Methods
Beetwen January 1989 and January 2009 in our department were accepted 152 patients with retroperitoneal tumors, others than kidney or adrenal gland. 101 males and 51 female were diagnosticated with primary or secondary retroperitoneal tumors. Clinical findings were represented by lumbar pain, tumor, digestive symptoms, fever, reno-vascular hypertension, and signs of compression (vena cava, vena porta). Imagistic evaluation was represented by abdominal ultrasound, IVP with major signs of urinary tract obstruction. CT and MRI represented the gold standard examinations. Imagistic protocol was completed with pulmonary radiography, renal and bone scintigraphy, Doppler ultrasound for vessels and digestive endoscopy. CT or ultrasound guided biopsy was not a routine in our department.
Results
Surgery was performed in 144 cases. The transperitoneal approach was considered in 96% of cases. Different operations were performed according to the extension and the stage of the tumor as follows: tumorectomy combined with nephrectomy and adrenalectomy, simple radical tumorectomy, vena cava resection, haematoma drainage, surgical cure of cyst, tumorectomy and bowel resection, duodenum resection, tumorectomy and caudal pancreatectomy, laparotomy and biopsy. The pathological study of retroperitoneal tumors was dominated by different sarcomatous types in 83 cases. Other patients presented various types of histological findings: neuroblastoma, benign soft tissue tumors, benign cysts, old haematoma, limphoma and some of them secondary, metastatic retroperitoneal tumors.
Conclusions
Retroperitoneal tumors were detected frequently in advanced stages, due to non-specific clinical signs and to their deep position. Pain, tumor and compression represented the main clinical findings. CT and MRI were a must for the evaluation of these tumors. Trans-peritoneal approach was preferred and different conditions such were invasion of neighborhood structures, extension and lymph node dissection were solved using this way. Because retroperitoneal tumors were in many cases sarcomas, which are well-known chimioand radio-resistent, surgery represented the main curative treatment.
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Copyright
© 2009 European Association of Urology. Published by Elsevier Inc. All rights reserved.
