软组织肉瘤切除后的修复重建

RECONSTRUCTION AND REPAIR AFTER RESECTION OF SOFT TISSUE SARCOMA

目的探讨修复重建在技术手术治疗软组织肉瘤中的作用和地位。方法１９９０年１１月～１９９６年１１月，治疗软组织肉瘤１０７例，其中３２例进行了一期修复重建手术。３２例中，恶性纤维组织细胞瘤１２例，滑膜肉瘤６例，脂肪肉瘤３例，神经纤维肉瘤３例，横纹肌肉瘤３例，皮隆突纤维肉瘤２例，纤维肉瘤２例，上皮样肉瘤１例；４例为原发，２８例为复发；外科分期为ⅠＢ３例，ⅡＡ３例和ⅡＢ２６例。根治性切除１３例，广泛切除１７例，局部切除２例。手术加化疗１３例，手术加放疗７例。血管重建３例，动力功能重建１６例，皮肤缺损修复２２例。结果术后随访到３０例，随访时间４个月～６年６个月，肉瘤局部控制率为８０％，血管重建保肢率为１００％，动力功能重建优良率为８７．５％，缺损组织修复成活率为９６％。结论修复重建是软组织肉瘤切除后外科治疗的延续，是减低肿瘤的复发率，提高患者生活质量的重要措施之一。

Objective To emphasize the importance of reconstruction and repair after resection of soft tissue sarcona. Methods From November 1990 to November 1996, in 107 cases of soft tissue sarcoma 32 cases had received various reconstructive or repairative operations. Among the 32 cases, 4 cases were primary sacomas and 28 cases were recur rent sacomas. In surgical grading, 3 cases were of ⅠB, 3 cases of ⅡA and 26 cases of ⅡB. Radical resection was performed in 13 cases, widen local resection in 17 cases and local excision in 2 cases. After operation, 13 cases received chemotherapy and 7 cases received radiotherapy. Reconstruction of blood vessels was performed in 3 cases, reconstruction of kinetic function in 16 cases, and repair of defect was carried out in 23 cases. Restults Thirty patients were followed up for 4 months to 6 years and 6 months. The clinical results showed that the local control rate of sarcoma was 80%, limb salvage rate after reconstruction of blood vessels was 100%, the excellent and good rate after reconstructon of kinetic function was 87.5%, and the survival rate of the tissue flap of transplantation and transposition was 96%. Conclusion It was conculded that the reconstruction and repair after resection of soft tissue sarcoma was the extension of operative treatmeat, and was very important in lowering the recurrence rate and improving the life quality of the sufferings.