四肢软组织低度恶性肿瘤的保肢治疗

摘要

目的：探讨四肢软组织低度恶性肿瘤的临床特点及保肢治疗的可行性。方法：2008年-2014年我院共34例四肢软组织恶性肿瘤患者：滑膜肉瘤11例，横纹肌肉瘤7例，脂肪肉瘤6例，腱鞘巨细胞瘤3例，平滑肌肉瘤3例，恶性纤维组织细胞瘤2例，软骨肉瘤1例，恶性肉芽肿1例。其中18例行肿瘤扩大切除术，6例行根除性切除术，5例行微波灭活瘤体切除术，3例行瘤段切除、离体灭活再植术，2例行局部切除术。根据患者具体情况术中给予皮瓣修复术。根据肿瘤性质和全身情况在术后给予放疗或化疗治疗。结果：全部34例患者均获得随访，随访时间（23.5±14.6）个月，其中3例患者复发，2例患者死亡。患肢功能良好。结论：对于四肢的软组织低度恶性肿瘤，及时给予扩大切除，微波灭活等合适的保肢治疗，可以取得良好的临床治疗效果和肢体功能恢复。%Objective:To study the limb salvage therapy of soft tissue neoplasms of low potential malignancy in limbs in order to reduce the recurrence and increase the living quality. Methods:All 34 cases with soft tissue neo-plasms of low potential malignancy in limbs were involved:11 synoviosarcomas,7 rhabdosarcomas,6 liposarcomas,3 giant cell tumor of tendon sheaths,3 leiomyosarcomas,2 malignant fibrous histiotomas,1 sarcoenchondroma,1 malig-nant granuloma. Among them,18 underwent extensive tumor resection,6 underwent radical resection,5 underwent mi-crowave inactivated tumors resection,3 underwent tumor resection and inactivated replantation in vitro,2 underwent local excision. According to the situation of tumor,skin flap repair were given. According to the nature of the tumor and the general situation,radiotherapy or chemotherapy were given after surgery. Results:All the 34 patients had the follow-up[(23. 5 ± 14. 6)months]. 3 patients had recurrence,2 patients died. Limb function was well. Conclusion:For the soft tissue neoplasms of low potential malignancyin limbs,appropriate limb-salvage treatment such as micro-wave inactivate is a better way of reducing local recurrence and increasing living quality.