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目的:探讨横行腹直肌肌皮瓣修复与肿瘤相关腹股沟区软组织缺损的临床价值。方法:2000-01-2009-01应用本法共修复腹股沟区软组织缺损12例,其中恶性纤维组织细胞瘤4例,滑膜肉瘤2例,鳞状细胞癌2例,恶性黑色素瘤转移2例,纤维瘤病1例,横纹肌肉瘤术后1例;原发3例,复发7例,放疗后切口溃烂2例(滑膜肉瘤、横纹肌肉瘤术后各1例);滑膜肉瘤术后放疗后复发1例。结果:围手术期腹直肌肌皮瓣移植,11例全部成活,1例部分坏死;11例平均随访15个月,1例失访;局部复发1例,肺、脑转移死亡3例,余8例均生存,供区无并发症出现。结论:腹直肌肌皮瓣修复腹股沟软组织缺损具有愈合快、抗感染力强、供区隐蔽以及手术操作方便等优点,可实行双组手术,宜于修复较大腹股沟区软组织缺损。
Objective: To investigate the clinical value of transverse rectus abdominis myocutaneous flap in the repair of soft tissue defects associated with tumor. Methods: Twelve cases of soft tissue defect were repaired in the inguinal region from January 2000 to January 2009 with 4 cases of malignant fibrous histiocytoma, 2 cases of synovial sarcoma, 2 cases of squamous cell carcinoma, 2 cases of malignant melanoma metastasis, 1 cases of fibromatosis, 1 case of rhabdomyosarcoma after surgery; 3 cases of primary, 7 cases of recurrence, 2 cases of incision ulceration after radiotherapy (synovial sarcoma, 1 case of rhabdomyosarcoma after surgery); Synovial sarcoma recurrence after radiotherapy 1 case. Results: Perioperative myocutaneous myocutaneous flap transplantation, 11 cases all survived, 1 case of partial necrosis; 11 cases were followed up for an average of 15 months, 1 case lost to follow-up; 1 case of local recurrence, 3 cases died of pulmonary and brain metastases All 8 patients survived without complications. CONCLUSION: Rectus myocutaneous flap can repair soft tissue defect of inguinal region with the advantages of fast healing, strong anti-infective ability, concealed donor site and convenient operation.