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目的:探讨广泛手术切除和外科重建在治疗韧带样瘤中的作用。方法:回顾分析我院2009年至2011年间收治的20例行广泛手术切除和外科重建的韧带样瘤病人。腹壁韧带样瘤12例,腹壁外韧带样瘤8例;女16例,男4例,中位年龄30(12～47)岁。结果:20例中,除1例姑息性切除、1例因切缘较近直接缝合修复外,其余18例均接受外科广泛切除。18例根治性切除的病例中,2例直接修复,10例巴德补片修复,1例自体腹外斜肌腱膜修复,3例下肢纤维瘤病病人行人工血管置换或肌肉功能重建,2例肠系膜纤维瘤病行消化道重建。其中,5例病人作了术后放疗。随访19例病人均无瘤生存至今。结论:外科广泛切除和外科重建是治疗韧带样瘤的主要治疗方式;对切缘较近者可以补充放疗。
Objective: To explore the role of extensive surgical resection and surgical reconstruction in the treatment of ligament-like tumors. Methods: A retrospective analysis of our hospital from 2009 to 2011 admitted 20 cases of extensive surgical resection and surgical reconstruction of ligament-like patients. There were 12 cases of abdominal wall ligament-like tumor and 8 cases of abdominal wall ligament-like tumor. There were 16 females and 4 males, with a median age of 30 to 12 years old. Results: In the 20 cases, except for 1 case of palliative resection and 1 case of direct suture repair due to the close margin, the remaining 18 cases were extensively surgically removed. In 18 cases of radical resection, 2 cases were repaired directly, 10 cases were repaired with Bad patch, 1 case was repaired with autologous abdominal oblique aponeurosis, 3 cases were treated with artificial vascular replacement or muscular function reconstruction in patients with lower limb fibroid disease, 2 cases Mesenteric fibroids line digestive reconstruction. Among them, 5 patients underwent postoperative radiotherapy. All 19 patients were followed up till now. CONCLUSION: Surgical resection and surgical reconstruction are the main treatment for ligament-like tumors. Radiotherapy may be supplemented for the patients with more advanced margins.