臀部恶性和侵袭性软组织肿瘤的外科治疗  

The surgery treatment of buttock in malignant and intermediate STS

作　　者：张如明[1] 张琥[1] 刘印文[1] 徐震球[1] 石瑛[1] 滕胜[2] 师英强[3] 

机构地区：[1]上海中医药大学附属曙光医院骨伤科,200021 [2]天津医科大学附属肿瘤医院 [3]复旦大学附属肿瘤医院

出　　处：《中国骨肿瘤骨病》2005年第1期5-9,共5页Chinse Journal Of Bone Tumor And Bone Disease

摘　　要：目的　探讨臀部软组织肉瘤屏障切除和臀部肿瘤分区修复的可能性和效果。方法　1992 年7月至2004年1月收治臀部肿瘤中资料完整者15例,男6例,女9例。年龄16～71岁,平均44.3岁。 软组织肉瘤12例中,11例采用屏障切除方法切除肿瘤,另4例行边缘切除或经瘤切除。9例作了11块肌 皮瓣覆盖缺损。2/15例重建了动力功能。结果　软组织肉瘤屏障切除者随访时间6～96个月,平均34.5 个月。其中2例复发,复发率18.1%,平均复发时间33个月。4例平均术后13个月死亡,屏障切除者占2 例。11块肌皮瓣中1例坏死20%,余全部成活。结论　屏障切除术是软组织肉瘤切除的理想术式,适应证 比根治性切除术更广,复发率低于广泛切除术,而可操作性优于广泛切除术。臀部缺损的划区肌皮瓣修复 方法简单,成功率高。Objective To explore the efficacy of barrier resection of buttock soft tissue sarcoma and principle of regional reconstruction of soft tissue defect after tumors resection. Methods From July 1992 to January 2004, 15 patients with malignant and intermediate buttock tumors underwent surgery, they were 6 males and 9 females, ages ranged from 16 to 71 and the average 44.3 years old. Soft tissue sarcomas were 12 cases and 11 were performed barrier resections and 4 marginal or intralesional resections. The myocutaneous flap transposition were prosecuted in 9cases(11 flaps). Results 11 cases of barrier resection were followed up from 6-96 months, average 34.5 months. 2 patient recurred (18.1%) ,average recurent time was 33 months . 4 patients died 13 months post-operatively and 2 experienced barrier resection. Conclusion barrier resection is an ideal method for surgical treatment and with lower recurrent rate than wide resection. The method of myocutenous flap transposition is simple and excellent for covering buttock defect of soft tissue after tumors resection.

关 键 词：广泛切除 软组织肉瘤 臀部肿瘤 肌皮瓣 侵袭性 缺损 复发率 恶性 软组织肿瘤 外科治疗 

分 类 号：R739.95[医药卫生—肿瘤]