Lawrence W
Division of Surgical Oncology, Massey Cancer Center, Medical College of Virginia, Richmond 23298.
Semin Surg Oncol. 1994 Sep-Oct;10(5):340-6. doi: 10.1002/ssu.2980100506.
Operative management of soft tissue sarcomas begins with the surgical biopsy. Incisional biopsy of an undiagnosed soft tissue mass allows optimal later definitive resection, this resection including the entire biopsy wound, as well as accomplishing an "adequate" margin around the sarcoma. The principles employed for this resection are those that lead to adequate gross and microscopic margins of normal tissue around the sarcoma while considering the limitations, in terms of physical disability, from the procedure itself. This operative strategy is described for various anatomic locations, such as the extremities, trunk, retroperitoneum, and head and neck; special problems with each of these primary sites are discussed.
软组织肉瘤的手术治疗始于手术活检。对未确诊的软组织肿块进行切开活检,有助于后续进行最佳的根治性切除,这种切除包括整个活检伤口,以及在肉瘤周围获得“足够”的切缘。该切除所采用的原则是,在考虑手术本身导致身体残疾限制的情况下,在肉瘤周围获得足够的大体和显微镜下正常组织切缘。本文针对不同解剖部位,如四肢、躯干、腹膜后以及头颈部,描述了这种手术策略,并讨论了每个主要部位的特殊问题。