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手术仍是肢体软组织肉瘤最重要的治疗方法。随着现代外科技术及治疗理念的变化,肢体肉瘤的手术已由截肢为主演变为保肢手术和功能重建相结合的模式,广泛切除是最常用的术式,切除范围至少应包括肿瘤周围1cm正常组织或相当厚度的筋膜组织。边缘切除结合辅助治疗可用于少数肿瘤邻近重要神经血管或骨骼的病人,但应保证肿瘤切除的彻底性。累及血管神经或骨骼的肉瘤往往需要进行重建。少数病人血管神经广泛受累,残肢功能不优于假肢时仍需要考虑截肢治疗。
Surgery is still the most important treatment of limb soft tissue sarcoma. With the change of modern surgical technique and treatment concept, the surgery of limb sarcoma has evolved from limb amputation to the combination of limb salvage surgery and functional reconstruction. Extensive resection is the most commonly used surgical procedure. The resection scope should include at least 1cm Normal tissue or a considerable thickness of fascia. Marginal resection combined with adjuvant therapy can be used for a few patients adjacent to important neurovascular or skeletal tumors, but should ensure the thoroughness of tumor resection. Sarcomas involving the nerves or bones of the blood vessels often require reconstruction. A small number of patients with extensive involvement of vascular nerves, residual limb function is not better than the prosthesis still need to consider amputation treatment.