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"lead": "это первичные новообразования, которые возникли из тканей, расположенных в этой области (ретикулярной, жировой, соединительной), фасций, мышц, кровеносных и лимфатических сосудов, лимфатических узлов. ",
"description": " Забрюшинные новообразования могут появиться в любом возрасте, но чаще встречаются у людей от 40 до 60 лет, в основном у женщин. Злокачественными оказываются 60 — 85% из них. Забрюшинная злокачественная опухоль обладает одной интересной особенностью. Она заключается в ее склонности к повторным рецидивам.",
"etiology": "<p>К сожалению, на сегодняшний день не выявлены причины возникновения опухолей забрюшинного пространства.</p>",
"pathogenesis": "<p>Выделяют:</p>\r\n<ul>\r\n<li>первичные опухоли забрюшинного пространства (исходят непосредственно из тканей данного пространства):\r\n<ul>\r\n<li>мезенхимальные (липома, липосаркома, лимфосаркома)</li>\r\n<li>неврогенные (вненадпочечниковые параганглиомы, которые развиваются из симпатических ганглиев, располагающихся по обе стороны от брюшной аорты)</li>\r\n<li>кисты и тератомы (данные опухолевые образования исходят из остатков эмбриональной ткани первичной мочеполовой системы);</li>\r\n</ul>\r\n</li>\r\n<li>вторичные забрюшинные опухоли - метастатическое поражение забрюшинного пространства (чаще всего поражаются поясничные и подвздошные лимфатические узлы).</li>\r\n</ul>",
"diagnostics": "<p>В диагностике опухолей забрюшинного пространства могут применяться: УЗИ, рентгенологические методы, МРТ, КТ. При обзорной рентгенографии может обнаруживаться тень образования, контуры которого не совпадают с контурами почки. Кроме того может обнаруживаться смещение почки имеющим место новообразованием. При экскреторной урографии также может обнаруживатся смещение органов (почка, мочеточник, мочевой пузырь). Помимо этого может иметь место картина нарушения уродинамики (оттока мочи). Больше информации позволяют получить МРТ и МСКТ. В некоторых случаях может применяться аортография.</p>",
"treatment": "<p>Самым надежным и эффективным методом лечения признан хирургический. Забрюшинная злокачественная опухоль, чаще обнаруженная на поздних стадиях, имеет большие размеры. На тот момент она уже тесно связана с сосудами и близлежащими органами, смещает и прорастает их. Все эти факторы требуют высококвалифицированного хирургического вмешательства. Бригада хирургов должна обладать опытом проведения операций на всех органах, включая сосуды. Квалификация анестезиологов и реаниматологов должна быть не менее высокого уровня.</p>\r\n<p> Лучевая терапия применяется до оперативного вмешательства с целью снизить риск имплантации опухолевых клеток во время операции. Послеоперационная лучевая терапия проводится в дополнение к хирургическому методу и в случае рецидивов. При наличии больших распадающихся новообразований проведение лучевой терапии противопоказано.</p>\r\n<p> Эффективность химиотерапии в лечении данного заболевания очень низкая. Она лишь немного снижает частоту развития рецидивов, но общие показатели выживаемости больных не меняет.</p>",
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"clinical_picture": "<p>Ранние симптомы при опухолях мезенхимального происхождения нередко отсутствуют. Опухоль достигает больших размеров, не встречая никакого сопротивления со стороны соседних органов, которые легко ею смещаются. Длительное время больные никаких болевых ощущений не испытывают. Одним из первых симптомов являются ощущение дискомфорта в брюшной полости, ноющие боли в животе и пояснице. Иногда опухоль обнаруживается случайно при ощупывании живота или когда появляется чувство тяжести в животе, обусловленное большой опухолью, или возникают симптомы со стороны соседних органов: тошнота, рвота, запор, вздутие и даже непроходимость кишечника, расстройство мочеиспускания.</p>\r\n<p>Физиологически активные параганглиомы дают такую же клиническую симптоматику, как феохромоцитомы.</p>\r\n<p>Кисты и тератомы лишь условно относят к доброкачественным опухолям. Около 10% тератом оказываются злокачественными, они дают метастазы в легкие, печень, лимфатические узлы.</p>\r\n<p>К поздним симптомам забрюшинных опухолей относятся повышение температуры тела, зависящее от распада опухоли, а также признаки, вызванные нарушением венозного и лимфатического оттока. Так, сдавленно воротной вены забрюшинной опухолью ведет к асциту и расширению подкожных вен живота («голова медузы»), сдавление нижней полой вены— к отеку и венозному застою в нижних конечностях, компрессия общей подвздошной вены проявляется отеком одной нижней конечности соответствующей стороны, давление на яичковую вену приводит к расширению вен семенного канатика на стороне поражения. Одышка также является поздним симптомом. Она может быть следствием давления опухоли на диафрагму или наступает при массивном метастазировании в легкие.</p>\r\n<p>Течение забрюшинной опухоли зависит в основном от ее гистологической структуры. Доброкачественные опухоли, в отличие от злокачественных, достигая иногда большой величины, мало отражаются на общем состоянии больного. Однако и они, продолжая расти, нередко настолько нарушают функцию соседних органов, что в конце концов приводят к гибели. Метастазы забрюшинных опухолей встречаются не часто — приблизительно у 30% больных.</p>",
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