Kita Kouji, Nakamura Tomoki, Tsujii Masaya, Kato Jiro, Hagi Tomohito, Asanuma Kunihiro, Sudo Akihiro
Department of Orthopedic Surgery, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu-City, Mie, 514-8507, Japan.
Eur J Orthop Surg Traumatol. 2020 Dec;30(8):1441-1446. doi: 10.1007/s00590-020-02723-1. Epub 2020 Jun 24.
We investigated the clinical outcomes of reconstruction using the latissimus dorsi (LD) flap after resection of soft-tissue sarcoma.
We analyzed 19 patients. Free LD flap was performed in 11 patients and pedicle flap in eight patients. The mean follow-up period after the surgery was 60 months.
The mean age at diagnosis was 57 years. The mean tumor size was 9.8 cm. The median size of the LD flap was 140 × 100 mm. The mean surgical duration and bleeding were 510 min and 602 mL, respectively. Complications included partial skin and soft-tissue necrosis (n = 3) and wound dehiscence (n = 2). No additional free flap was not necessary for the closure of the defect due to the complications. The longer surgical duration was significantly associated with wound complications (P = 0.048). The 5-year survival rate was 80.7%, and the local recurrence-free survival rate was 89.2%. Two patients developed local recurrence, while 6 patients developed metastasis. None of the patients had any restrictions of daily life.
The LD flap after surgical tumor resection in patients with soft-tissue sarcoma was useful for the coverage of soft tissue.
我们研究了背阔肌（LD）皮瓣修复软组织肉瘤切除术后的临床效果。
我们分析了19例患者。11例行游离LD皮瓣修复，8例行带蒂皮瓣修复。术后平均随访时间为60个月。
诊断时的平均年龄为57岁。平均肿瘤大小为9.8厘米。LD皮瓣的中位大小为140×100毫米。平均手术时间和出血量分别为510分钟和602毫升。并发症包括部分皮肤和软组织坏死（n = 3）和伤口裂开（n = 2）。因并发症导致的缺损闭合无需额外的游离皮瓣。手术时间较长与伤口并发症显著相关（P = 0.048）。5年生存率为80.7%，局部无复发生存率为89.2%。2例发生局部复发，6例发生转移。所有患者的日常生活均无任何限制。
软组织肉瘤患者手术切除肿瘤后使用LD皮瓣有助于覆盖软组织。
