近年本院手术切除17例儿童臀部硬纤维瘤,初期有5例局部复发,以后对复发或原发肿瘤均从髂嵴剥离髂骨外板骨膜直达坐骨切迹暴露坐骨神经,使能广泛切除肿块和剥离坐骨神经,复发病例中除1例因不同意再次手术外,16例术后随访平均5年未再复发,且情况良好.%In recent 13 years,17 children with gluteal desmoid underwent a total excision.5 done in the beginging years had local recurrence in 7 months to 3 years after operation,and 2 of them had a second recurrence.Outward infiltration of the tumor and its potential low grade malignancy demand a radical extirpation.But a total excision is usually handicapped by the firm fixation of the tumor mass and extensive adhesion of the embedded sciatic nerve.Wide excision of the tumer mass and its surrounding normal tissue together with the local periosteum of the ilium from the iliac crest down to thegreater sciatic notch will be able to mobilize the tumor on bloc downward and posteriorly,so that the sciatic nerve could be freed from the posterier aspect of the tumor.Chips of bone adherent to the tumor should be chiseled off at the same time 16 cases including one who refused re-operation achieved satisfactory results without recurrence in an average of 5 years follow-up.
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