Plastic and Reconstructive Surgical Service, Center for Advanced Reconstruction, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA.
Division of Plastic and Reconstructive Surgery, Department of Surgery, Washington University School of Medicine in St. Louis, 660 South Euclid Avenue, Suite 1150 NWT, St Louis, MO 63110, USA.
Clin Plast Surg. 2021 Apr;48(2):307-319. doi: 10.1016/j.cps.2021.01.007. Epub 2021 Feb 11.
Surgical resection with wide margins and perioperative radiation therapy is the standard treatment of extremity soft tissue sarcomas. This combination often results in complex wounds and functional compromise. Reconstructive surgery is integral to limb salvage after sarcoma resection. Advances in adjuvant therapy and reconstructive surgical techniques have made functional limb salvage, instead of amputation, possible for most patients. This article reviews key concepts in the multidisciplinary care of patients with extremity soft tissue sarcomas and details reconstructive surgical techniques, including locoregional and free tissue transfer, free functional muscle transfer, and vascularized bone transfer, to optimize functional limb restoration after sarcoma resection.
手术切除加广泛的边缘和围手术期放射治疗是肢体软组织肉瘤的标准治疗方法。这种联合治疗通常会导致复杂的伤口和功能障碍。在肉瘤切除后，重建手术是保肢的关键。辅助治疗和重建手术技术的进步使大多数患者能够实现功能性保肢，而不是截肢。本文回顾了肢体软组织肉瘤患者多学科治疗的关键概念，并详细介绍了重建手术技术，包括局部和游离组织转移、游离功能性肌肉转移和带血管骨转移，以优化肉瘤切除后肢体的功能恢复。
