Lazerges C
Chirurgie de la main et du membre supérieur, chirurgie des nerfs périphériques, hôpital Lapeyronie, CHRU de Montpellier, 191, avenue du Doyen-Gaston-Giraud, 34295 Montpellier cedex 5, France.
Hand Surg Rehabil. 2017 Sep;36(4):233-243. doi: 10.1016/j.hansur.2016.12.010. Epub 2017 Jun 16.
Soft tissue sarcoma of the forearm, wrist and hand are rare. Their benign appearance leads often to primary inadequate treatment. Due to the complex anatomy of the hand and forearm, they are challenging to treat. The two goals are to obtain wide resection of the primary tumor while preserving function. Limb-sparing surgery is now the cornerstone for the treatment of most sarcomas of the forearm, hand and wrist. To achieve optimal oncological and functional outcomes, the surgical excision should be associated with early reconstructive procedures and a multidisciplinary meeting to define the treatment strategy including adjuvant medical treatments. This article outlines the current principles and presents the results of the treatment of soft tissue sarcomas with emphasis on to particularities related to their forearm, wrist and hand location.
前臂、手腕和手部的软组织肉瘤较为罕见。其良性外观常常导致初始治疗不充分。由于手部和前臂解剖结构复杂,它们的治疗颇具挑战性。两个目标是在保留功能的同时广泛切除原发性肿瘤。保肢手术如今是治疗前臂、手部和手腕大多数肉瘤的基石。为实现最佳的肿瘤学和功能结果,手术切除应与早期重建手术以及多学科会诊相结合,以确定包括辅助药物治疗在内的治疗策略。本文概述了当前的原则,并介绍了软组织肉瘤的治疗结果,重点关注与前臂、手腕和手部位置相关的特殊性。