40例足部黑色素瘤的外科治疗体会  

Experience of surgical treatment of 40 cases of foot melanoma

作　　者：王刚[1] 孙玉亮 崔宜栋 裴艳涛[1] 许庆家[1] 朱磊[1] Wang Gang;Sun Yuliang;Cui Yidong;Pei Yantao;Xu Qingjia;Zhu Lei(Hand and foot surgery,Qilu Hospital of Shandong University,Jinan 250012,China)

机构地区：[1]山东大学齐鲁医院手足外科,山东济南250012

出　　处：《足踝外科电子杂志》2022年第2期16-20,I0001,共6页Electronic Journal of Foot and Ankle Surgery

摘　　要：目的通过总结40例足部恶性黑色素瘤的外科治疗,探讨足部恶性黑色素瘤的规范化外科治疗。方法回顾性分析了2019年1月至2022年1月山东大学齐鲁医院收治的40例足部恶性黑色素瘤患者,其中足趾恶性黑色素瘤8例、跖底恶性黑色素瘤12例、足跟部恶性黑色素瘤20例。术前通过查体、病理检查和淋巴结B超等检查方式来证实足部肿瘤的性质以及相对应的腹股沟淋巴结是否有肿大,给予患者扩大切除原发灶、创面修复以及前哨淋巴结活检等治疗,后对淋巴结病理阳性患者再次给予腹股沟淋巴结清扫手术。结果患者术后于肿瘤科就诊指导下一步治疗,40例患者中有1例术后5个月复发,再次行手术治疗,治疗后恢复良好;其余39例均未复发,预后良好。结论足部恶性黑色素瘤患者的外科规范化治疗是后期综合治疗的前提,能够改善足部恶性黑色素瘤患者的预后。Objective Through summarizing the surgical treatment of 40 cases of malignant melanoma of the foot,to explore the standardized surgical treatment of malignant melanoma of the foot.Methods A total of 40 patients with malignant melanoma of the foot admitted to Qilu Hospital of Shandong University from January 2019 to January 2022 were retrospectively analyzed,including 8 cases of malignant melanoma of the toes,12 cases of malignant melanoma of the plantar floor,and 20 cases of malignant melanoma of the heel.Before the operation,physical examination,pathological examination and B-ultrasound of lymph nodes were used to confirm the nature of the foot tumor and whether the corresponding inguinal lymph nodes were swollen.The patients were treated with expanded resection of the primary focus,wound repairment and sentinel lymph node biopsy.After that,the patients with positive lymph node pathology were given inguinal lymph node dissection again.Results After the operation,the patients went to the oncology department to guide the next step of treatment.One of the 40 patients had recurrence 5 months after surgery,and was treated again and recovered well.The other 39 cases did not relapse and had a good prognosis.Conclusion Standardized surgical treatment of patients with malignant melanoma of the foot is the premise of comprehensive treatment,and can improve the prognosis of patients with malignant melanoma of the foot.

关 键 词：恶性黑色素瘤 规范化外科治疗 前哨淋巴结清扫术 

分 类 号：R739.5[医药卫生—肿瘤]