腹股沟部原发恶性软组织肉瘤的治疗

Treatment of primary malignant soft tissue sarcoma in the inguinal region

目的:通过回顾性总结腹股沟软组织肉瘤的临床病理特征、治疗方式,总结该部位软组织肉瘤的治疗特点,探讨其治疗效果。方法:选择2010年8月—2016年8月治疗的腹股沟区软组织肉瘤患者12例。手术方式:4例包括肿瘤连同累及周围的动静脉切除,1例肿瘤连同动脉切除,2例肿瘤连同静脉切除,5例行动脉置换手术。结果:随访期间出现并发症5例(41.7%),包括淋巴漏3例,切口皮瓣坏死1例,置换动脉血栓形成1例。2例(16.7%)出现局部复发,4例随访期间因肺转移死亡,1例带病生存,1例死于其他疾病。患者的术后肢体功能评分平均为92.5%。Kaplan-Meier曲线预测患者的5年生存率分别为64.8%。结论:腹股沟区软组织肉瘤有着较高的血管受累概率。连同血管的整块切除可以减少肿瘤复发。肿瘤连同静脉切除后静脉不重建,通过适当的措施可以控制肢体肿胀。

Objective:To evaluate surgical strategy,the functional status,survival results and the complication rate of a cohort of patients with soft tissue sarcomas in the groin region.Methods:Twelve consecutive patients between August 2010 and August 2016 who received resections of soft tissue sarcomas in the groin region were evaluated.Four patients underwent tumor resections with the involved femoral artery and femoral vein,one patient with the involved femoral artery,two patients with the involved femoral vein.Five patients received femoral artery reconstruction with either great saphenous vein autograft or synthetic vessels graft.Results:There were 5 patients(41.7%)with complications during follow-up,including 3 patients with lymphatic leakage,1 with incision flap necrosis,and 1 with replacement arterial thrombosis.Local recurrence occurred in 2 patients(16.7%),4 patients died of lung metastasis during follow-up,1 patient survived with disease,and 1 patient died of other diseases.The patient's postoperative limb function score was an average of 92.5%.The 5-year survival rate for patients predicted by Kaplan-Meier curve was 64.8%.Conclusion:The soft tissue sarcoma in the groin region has a high major vessel involvement rate.The resection of the sarcoma with the involved major vessels may reduce local recurrence.The reconstruction of the femoral artery was mandatory,while the reconstruction of the femoral vein was not necessary.