股前外侧嵌合穿支皮瓣联合人工材料修复腹壁肿瘤切除术后巨大缺损的临床效果  

Clinical efficacy of anterolateral thigh chimeric perforator flap combined with artificial materials for repairing huge defects following abdominal wall tumor resection

作　　者：陈璐[1,2,3] 洪晓悦 刘柏岐 郭蓉 唐举玉[4] 吴攀峰[4] 黄耿文[1,2,3] CHEN Lu;HONG Xiaoyue;LIU Baiqi;GUO Rong;TANG Juyu;WU Panfeng;HUANG Gengwen(Hernia and Abdominal Wall Surgery Center,Hand&Microsurgery,Xiangya Hospital,Central South University,Changsha 410008,China;Department of General Surgery,Hand&Microsurgery,Xiangya Hospital,Central South University,Changsha 410008,China;National Clinical Medical Research Center for Geriatric Diseases,Hand&Microsurgery,Xiangya Hospital,Central South University,Changsha 410008,China;Department of Orthopedics,Hand&Microsurgery,Xiangya Hospital,Central South University,Changsha 410008,China)

机构地区：[1]中南大学湘雅医院疝和腹壁外科中心,湖南长沙410008 [2]中南大学湘雅医院普通外科,湖南长沙410008 [3]中南大学湘雅医院国家老年疾病临床医学研究中心,湖南长沙410008 [4]中南大学湘雅医院骨科手显微外科,湖南长沙410008

出　　处：《中国普通外科杂志》2025年第2期338-345,共8页China Journal of General Surgery

摘　　要：背景与目的:腹壁肿瘤切除术后腹壁巨大缺损的重建修复是外科医生面临的难题。本研究总结笔者团队在多学科协作下,采用股前外侧嵌合穿支皮瓣联合人工材料技术修复腹壁肿瘤切除术后巨大腹壁缺损的经验,以期为同行提供参考与借鉴。方法:回顾性分析2019年10月—2024年4月中南大学湘雅医院连续收治的7例采取股前外侧嵌合穿支皮瓣联合人工材料技术一期修复腹壁恶性肿瘤切除术后巨大腹壁缺损患者的临床与病理资料,评价其临床效果。结果:7例患者的腹壁肿瘤切除术与一期腹壁重建均顺利完成,无手术相关死亡。所有患者修复后的创面均一期愈合,无外科部位感染、皮瓣坏死等严重并发症发生。术后随访6~54个月,2例术后肿瘤复发,其中1例死亡(具体原因不详),1例继续抗肿瘤治疗,其余5例均无瘤存活。1例患者出现腹壁膨出,所有患者无明显切口疝形成。结论:对腹壁肿瘤切除术后造成的腹壁巨大缺损,采用股前外侧嵌合穿支皮瓣联合人工材料技术进行修复可获得较理想的治疗效果,是一种可行且安全的修复方式。Background and Aims:Reconstructing huge abdominal wall defects after abdominal wall tumor resection is a significant challenge for surgeons.Here,we summarize the experience of our team in repairing these defects using an anterolateral thigh chimeric perforator flap combined with artificial materials,within a multidisciplinary collaborative framework,aiming to provide a reference for other practitioners.Methods:The clinicopathologic data of 7 patients who underwent primary reconstruction of large abdominal wall defects after malignant tumor resection,using an anterolateral thigh chimeric perforator flap combined with artificial materials,at Xiangya Hospital,Central South University,between October 2019 and April 2024,were retrospectively analyzed.The clinical outcomes were evaluated.Results:All 7 patients successfully underwent both tumor resection and primary abdominal wall reconstruction without surgery-related mortality.The wound in all patients healed in one stage,with no severe complications such as surgical site infections or flap necrosis.During a follow-up period of 6 to 54 months,2 patients experienced tumor recurrence,one of whom died(exact cause unknown),while the other continued anti-tumor treatment.The remaining 5 patients were alive without recurrence.One patient developed abdominal wall bulging,but no obvious incisional hernia occurred in any of the patients.Conclusion:The use of an anterolateral thigh chimeric perforator flap combined with artificial materials for repairing large abdominal wall defects after abdominal tumor resection can achieve satisfactory therapeutic outcomes.This approach is a feasible and safe method for abdominal wall reconstruction.

关 键 词：修复外科手术 腹壁 穿支皮瓣 外科网 

分 类 号：R62[医药卫生—整形外科]