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腹腔内假体在硬纤维瘤手术中的腹壁重建。

Abdominal wall reconstruction with intraperitoneal prosthesis in desmoid tumors surgery.

机构信息

Università di Catania, Catania, Italy.

出版信息

Updates Surg. 2012 Mar;64(1):43-8. doi: 10.1007/s13304-011-0109-0. Epub 2011 Oct 14.

Abstract

Desmoid tumor (DT), also known as aggressive fibromatosis, is a rare soft tissue neoplasm. For those tumors localized in the anterior abdominal wall, radical resection and reconstruction with mesh are indicated. Due to the rarity of this disease, there have been no randomized trials, but in reported retrospective series, although it is considered a benign lesion, it is clear that local recurrence is not uncommon. Records from seven consecutive patients (1 man, 6 women; mean age 35 years, range 25-60 years) presenting with desmoid tumors of the anterior abdominal wall were analyzed. In all cases the surgical strategy was the same: wide surgical excision and immediate plastic reconstruction with ePTFE mesh after intraoperative confirmation by frozen section of disease-free margins >1 cm. No immediate postoperative complications were recorded, and no patients developed recurrence after a median follow-up period of 60 months. The long-term mean of global health status recorded was 100%. Radical resection aided by intraoperative margin evaluation by frozen sections, followed by immediate mesh reconstruction, is a safe procedure and can provide a definitive cure without functional limitations for patients with desmoid tumors of the anterior abdominal wall.

摘要

腹壁侵袭性纤维瘤(desmoid tumor,DT),又称硬纤维瘤,是一种罕见的软组织肿瘤。对于局限于前腹壁的肿瘤,应行根治性切除和网片重建。由于这种疾病较为罕见,尚未有随机试验,但在已报道的回顾性系列研究中,尽管侵袭性纤维瘤被认为是良性病变,但明确的局部复发并不少见。分析了连续 7 例(1 男,6 女;平均年龄 35 岁,范围 25-60 岁)前腹壁侵袭性纤维瘤患者的记录。所有病例的手术策略均相同:广泛切除肿瘤后,在术中冰冻病理证实切缘>1cm 无肿瘤残留的情况下立即用 ePTFE 网片进行整形重建。未记录到任何术后即刻并发症,中位随访 60 个月后无患者复发。记录的长期平均总体健康状况为 100%。通过术中冰冻病理评估切缘,辅助根治性切除,然后立即进行网片重建,是一种安全的方法,可以为前腹壁侵袭性纤维瘤患者提供无功能限制的确定性治愈。

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