腹直肌肌皮瓣修复肿瘤相关腹股沟区软组织缺损临床价值的探讨  

Repair of tumor-related soft tissue defects in the inguinal region by transverse rectus abdominis myocutaneous flap

作　　者：靳迎军[1] 李保中[1] 刘志强[1] 贾海全[1] 邱献华[1] 

机构地区：[1]河南省安阳市肿瘤医院外科,河南安阳455000

出　　处：《中华肿瘤防治杂志》2011年第19期1563-1565,共3页Chinese Journal of Cancer Prevention and Treatment

摘　　要：目的:探讨横行腹直肌肌皮瓣修复与肿瘤相关腹股沟区软组织缺损的临床价值。方法:2000-01-2009-01应用本法共修复腹股沟区软组织缺损12例,其中恶性纤维组织细胞瘤4例,滑膜肉瘤2例,鳞状细胞癌2例,恶性黑色素瘤转移2例,纤维瘤病1例,横纹肌肉瘤术后1例;原发3例,复发7例,放疗后切口溃烂2例(滑膜肉瘤、横纹肌肉瘤术后各1例);滑膜肉瘤术后放疗后复发1例。结果:围手术期腹直肌肌皮瓣移植,11例全部成活,1例部分坏死;11例平均随访15个月,1例失访;局部复发1例,肺、脑转移死亡3例,余8例均生存,供区无并发症出现。结论:腹直肌肌皮瓣修复腹股沟软组织缺损具有愈合快、抗感染力强、供区隐蔽以及手术操作方便等优点,可实行双组手术,宜于修复较大腹股沟区软组织缺损。OBJECTIVE： To explore the clinical value of transverse rectus abdominis myocutaneous flap（TRAM）in treating tumor-related soft tissue defects in the inguinal region. METHODS： From January 2000 to January 2009,12 cases of tumor related soft tissue defects in the ingui nal region were treated with TRAM. There were 4 cases of malignant fibrous histiocytoma,2 cases of synovial sarcoma, 2 cases of squamous cell carcinoma,2 cases of melanoma metastasis,one case of fibromatosis and one case of postoperative of rhabdomyosarcoma; There were 3 cases of primary tumor, 7 cases of recurrent tumors and two cases of ulceration after radiother- apy （1 cases of synovial sarcoma and 1 case of rhabdomyosarcoma） ; There was one cases of recurrence of synovial sarcoma after operation and radiotherapy. RESULTS： All the flaps survived except one flap that developed a partial necrosis in the perioperative period; all cases were followed up for averaged 15 months except one patient was missed. In the followed period 3 patients died of lung or brain metastasis and 1 patient got local recurrence, and there was no donor site complication. CONCLUSIONS：Repair of soft tissue defects in the inguinal region by TRAM has many advantages,such as rapid healing, strong resistance to infection, donor site hidden, simple procedure. This method can implement dual operation and appropriate to fix a larger area of soft tissue defects.

关 键 词：软组织肿瘤 腹股沟/外科学 软组织损伤/外科学 腹直肌 外科皮瓣 修复外科手术 

分 类 号：R738[医药卫生—肿瘤]