手部复发性腱鞘巨细胞瘤手术治疗

Surgical treatment for recurrent giant cell tumor of tendon sheath of hand

目的 探讨手部复发性腱鞘巨细胞瘤的手术治疗方法。方法 采用指掌部锯齿形切口，在手术放大镜下操作，保留滑车，将肿块连同受累的屈肌腱鞘及滑液鞘全部切除。结果 １２ 例随访１～６ 年，无一例复发，手指屈伸功能恢复正常。结论 手部腱鞘巨细胞瘤手术不仅要切除瘤体，还要切除瘤体附近的腱鞘、滑膜组织，对于呈串珠状多发性腱鞘巨细胞瘤且腱鞘被侵及的病例，可选择保留Ａ１ 、Ａ２ 、Ａ４ 滑车的全腱鞘切除术。

Objective\ To investigate surgical treatment for the recurrent giant cell tumor of tendon sheath of hand. Methods\ Zigzag incision was cut in the side of palm of fingers and the operation was performed under the magnifying glass with the trochleae retained. The mass was removed with affacted tenden sheath and synovium sheath. Results\ 12 patients were treated. No one recurred after 1～6 years of follow up. The fingers recovered normal flexion and extension.Conclusion\ The operation should not only resect tumors, but the tendon sheath surrounding the tumors and the synovium as well as for the cases of string of beads shaped multiple giant cell tumor of tendon sheath with the tendon sheath invaded, the whole tendon sheath should be resected with A 1、A 2、A 4 trochleae retained.