体表中间型软组织肿瘤的整形外科治疗

Plastic Surgical Treatment of Superficial Interphyletic Soft Tissue Tumor

目的总结体表中间型软组织肿瘤的手术治疗经验及其疗效。方法33例体表中间型软组织肿瘤，其中25例（75．8％）为术后复发病例，8例为首次病例，均行肿瘤扩大切除术，在足够的深度、广度下切除肿瘤，一期修复创面。结果本组行邻近皮瓣＋皮片移植修复18例，远位皮瓣＋皮片移植修复7例，皮片移植修复8例。3例游离皮片部分坏死，补充植皮后创面修复；1例后斜角肌肌瓣坏死后锁骨外露，行胸大肌肌瓣转移＋皮片移植后创面修复。随访0．5～4年无一例复发。结论对中间型软组织肿瘤手术治疗时需注意切除的深度和广度，以减少复发机率；采用整形外科技术修复创面可获得满意效果。

Objective To summarize the clinic experience and therapeutic effect of surgical treatment for interphyletic soft tissue tumor on body surface. Methods 33 patients with superficial interphyletic soft tissue tumor were analyzed retrospectively, including 25 of palindromic cases and 8 of primary cases. Tumors were extensive rcsected in vertical and horizontal extent. Surgical excision of tumor and reconstruction were accomplished simultaneously in all cases. Results Reconstruction were completed with adjacent skin flap and free skin grafting in 18 cases, distant skin flap and free skin grafting in 7 cases, and free skin transplantation in 8 cases. Partial necrosis of skin grafts occurred in 3 cases, and was repaired by skin grafting again. Clavicle exposure associated with necrosis of scalenus posterior muscle flap was found in 1 case, then was repaired by musculocutaneous flaps transfering and free skin grafting. No case relapsed during 0.5 to 4 years follow-up. Conclusion During the surgical treatment of interphyletic soft tissue tumor, the depth and extent of tumor excision must be pay more attention to decrease the recurrence rate, and the plastic surgical techniques can be achieved satisfactory outcome to repair the wounds.