Szentimrey D
Rocky Mountain Surgery Services, Calgary, Alberta, Canada.
Clin Tech Small Anim Pract. 1998 Feb;13(1):70-6. doi: 10.1016/S1096-2867(98)80031-5.
Small animal oncologic surgery is a relatively new and rapidly expanding field of veterinary science. Many exciting and innovative techniques for surgical resection of invasive tumors have been developed and published in the last decade. Paralleling these developments have been major advancements in the frontiers of reconstructive options to close the defects after major ablative surgery. A more thorough understanding of the biologic behavior of tumors in our patients has permitted us to rationally approach selected patients with high doses of surgery with curative intent, palliation, or as part of a multimodality treatment plan. Invasive oncologic procedures require thorough preoperative planning and staging to accomplish the goal of tumor-free margins. Patient factors, specifically tumor type, grade, anatomic location, and extent of local invasion, will subsequently dictate the appropriate resection and reconstructive options available. Resection of the tumor with a wide margin of normal tissue is the surgeon's primary objective. The reconstructive phase of the surgery endeavors to restore functional and cosmetic integrity to the regional anatomy. Each resection and reconstruction procedure must be customized for the patient's disease. Thoughtful preoperative planning, timing, and intraoperative flexibility to unforeseen circumstances will minimize complications. Armed with a number of reconstructive options for each case, the surgeon develops intraoperative flexibility and latitude to be more aggressive during the primary resection. If the surgeon self-imposes limitations on the aggressive removal of the primary tumor by virtue of tissue closure concerns, the completeness of resection and patient survival may well be jeopardized. As familiarity and experience with different reconstructive options increases, the surgeon will have greater confidence in removing large volumes of diseased tissue.
小动物肿瘤外科是兽医学中一个相对较新且迅速发展的领域。在过去十年中，已经开发并发表了许多用于手术切除侵袭性肿瘤的令人兴奋且创新的技术。与这些发展并行的是，在大型切除性手术后用于闭合缺损的重建选择前沿取得了重大进展。对我们患者肿瘤生物学行为的更深入了解使我们能够合理地对选定患者采用高剂量手术，目的是治愈、缓解症状或作为多模式治疗计划的一部分。侵袭性肿瘤手术需要全面的术前规划和分期，以实现切缘无肿瘤的目标。患者因素，特别是肿瘤类型、分级、解剖位置和局部侵犯范围，随后将决定可用的适当切除和重建选择。在正常组织的宽 margins 范围内切除肿瘤是外科医生的主要目标。手术的重建阶段致力于恢复局部解剖结构的功能和美观完整性。每个切除和重建程序都必须针对患者的疾病进行定制。周到的术前规划、时机选择以及对意外情况的术中灵活性将使并发症降至最低。对于每个病例都有多种重建选择，外科医生在术中具有灵活性和自由度，以便在初次切除时更积极主动。如果外科医生由于担心组织闭合而自行对原发性肿瘤的积极切除施加限制，那么切除的完整性和患者的生存率很可能会受到危及。随着对不同重建选择的熟悉程度和经验的增加，外科医生在切除大量病变组织时将更有信心。
