游离股前外侧皮瓣在小腿软组织肉瘤切除术后软组织缺损修复中的临床应用

doi:10.3760/cma.j.cn101202-20190902-00274

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摘要目的探讨游离股前外侧皮瓣在小腿前侧软组织肉瘤切除术后软组织缺损修复中的临床应用效果。方法回顾性分析2014年6月—2018年6月河南省肿瘤医院骨软组织科收治的13例小腿软组织肉瘤切除术后软组织缺损患者的临床资料。其中男8例,女5例;年龄20～52岁,平均38岁。未分化多形性肉瘤5例,滑膜肉瘤4例,平滑肌肉瘤2例,上皮样肉瘤1例,黏液性纤维肉瘤1例。患者软组织肉瘤均行手术切除,切除术后软组织缺损面积5.5 cm×6.5 cm～13 cm×7 cm。应用游离股前外侧皮瓣一期修复软组织缺损,切取皮瓣面积7 cm×8 cm～14 cm×8 cm,术后观察皮瓣成活情况,以及肿瘤复发、转移情况。术后6周从皮瓣愈合、外形、温度、感觉以及供区瘢痕5个方面评价移植皮瓣的疗效。结果患者均顺利完成手术。13例皮瓣全部成活,创面愈合良好。其中1例术后24 h出现静脉危象,经探查重新吻合血管后皮瓣成活;1例因创面感染皮瓣远端延迟愈合。13例患者均获随访9～57个月,平均24.5个月。13例皮瓣外形好,外观无臃肿,温度正常,皮瓣感觉部分存在。其中3例放疗后皮瓣局部色素沉着、质地变硬,但无皮瓣坏死;余皮瓣色泽和质地均良好。移植皮瓣疗效评分7～9分,疗效满意。随访期间患肢可负重行走,无供区肿瘤种植。无瘤生存10例,其中因肿瘤复发行小腿截肢术1例;肺转移3例,其中带瘤生存1例,死亡2例。结论应用游离股前外侧皮瓣一期移植修复小腿前侧软组织肉瘤切除术后软组织缺损,具有可避免皮瓣供区肿瘤种植、皮瓣血供可靠、对供区创伤小、外形满意等优势,是一种修复小腿肉瘤术后软组织缺损的可靠手术方法。

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	刘志勇
	王鑫
	姚伟涛
	王家强
	张鹏
	田志超
	李超
	牛晓颖
	刘贯聪

关键词 ：软组织肿瘤, 肉瘤, 小腿, 软组织缺损, 游离组织瓣, 股前外侧皮瓣, 外科,整形

Key words： Soft tissue neoplasms Sarcoma Leg Soft tissue defects Free tissue flaps Anterolateral thigh flap Surgery, plastic

收稿日期: 2019-09-02

通讯作者: 王鑫,Email: superwx1984@163.com

引用本文:

刘志勇, 王鑫, 姚伟涛, 王家强, 张鹏, 田志超, 李超, 牛晓颖, 刘贯聪. 游离股前外侧皮瓣在小腿软组织肉瘤切除术后软组织缺损修复中的临床应用[J]. 中华解剖与临床杂志, 2020, 25(4): 433-437.
Liu Zhiyong, Wang Xin, Yao Weitao, Wang Jiaqiang, Zhang Peng, Tian Zhichao, Li Chao, Niu Xiaoying, Liu Guancong. Application of anterolateral thigh flap in repair of limb soft tissue defect following the resection of the lower leg soft tissue sarcoma. Chinese Journal of Anatomy and Clinics, 2020, 25(4): 433-437.

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http://www.cjac.com.cn/CN/10.3760/cma.j.cn101202-20190902-00274 或 http://www.cjac.com.cn/CN/Y2020/V25/I4/433

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