胸壁肿瘤切除后涤纶布修补巨大胸壁缺损42例临床分析.docVIP

胸壁肿瘤切除后涤纶布修补巨大胸壁缺损42例临床分析 　　作者：谷兰海，杜庆霞 作者单位：1. 276000 山东省临沂市肿瘤医院胸外科; 2. 临沂市兰山区第一医院 　　【摘要】 目的 探讨胸壁肿瘤切除后胸壁重建的方法。方法 自1990年10月至2004年6月对42例胸壁肿瘤切除后行涤纶布修补重建，将涤纶布修剪成大小及形状与缺损胸壁相仿，缝合于缺损胸壁边缘的软组织上，然后行皮肤软组织修复，局部加压包扎。结果 本组无手术死亡及严重并发症发生。并发症发生率为12%，其中皮下积液1例，心律失常4例。随访5个月～5年，4例良性肿瘤无复发，恶性肿瘤的1、3、5年生存率分别为86.8%[57.9%[36.8%。结论 胸壁肿瘤切除有较好的愈后，应积极手术治疗。涤纶布修补胸壁缺损具有组织相容性好，有一定的韧性及弹性，手术操作简单，并发症少等优点。 　　【关键词】 胸壁肿瘤;外科手术;胸壁缺损;涤纶布 　　42 Cases Clinical Study of Repair and Reconstruct Mass Chestwall Defect by Dacron after Tumor Resection 　　GU Lanhai1, DU Qinxia2 　　1.Department of Thoracic Surgery, Linyi Tumor Hospital, Shandong 27600, China;2. The First Hospital of Lanshan District LinyicityAbstract：Objective To study the operating procedure and reconstruct mass chestwall defect by dacron.Methods From 1990, 10 to 2004, 6, 42 patients underwent chest resection using dacron to reconstruct the chestwall. Make its form become the same as the defect chest and sew it to chest tissue, then sew up the chest tissue by procedure, last bind it with pressure. Results There were no operating death and serious complication. 5 cases (12%) has postoperative complication. Among them local effusion under skin 1 case, cardiac arrhythmia 4 cases. 1,3,5 years survival with malignant tumor were 86.5%, 57.9%, 36.8% respectively. Conclusion Surgical resection of chestwall tumor is a safe and effective treatment, that should be positive is treated. Repair and reconstruct mass chestwall defect by dacron is not only have good tissue compatible, flexibility and elasticity but also have many advantages such as easy to operate, little complication. 　　Key words： Chestwall tumor; Surgical operation; Chestwall defect; Dacron 　　巨大胸壁肿瘤根治性切除后常导致胸壁大块缺损，特别当骨性胸壁大块缺损时，须做修复重建，目前修复重建的方法较多，作者自1990年10月～2004年6月对胸壁缺损应用涤纶布进行修补，取得了满意效果，现报道如下。 　　1 资料与方法 　　1.1 一般资料 本组42例，男25例，女17例，年龄12～68岁，平均年龄52.7岁。良性肿瘤4例，其中血管瘤3例，骨巨细胞瘤1例。恶性肿瘤38例，其中肺癌侵及胸壁20例，乳腺癌局部复发侵犯骨性胸壁6例，软骨肉瘤3例，恶性纤维组织细胞瘤4例，横纹肌肉瘤3例，神经纤维肉瘤2例。 　　1.2 病灶部位及