CAJ | 학술논문

目的回顾性分析手指原发软组织肉瘤病例,判断在根治肿瘤的同时是否能实施保指以满足手指外观功能的需要.方法收集2007年4月至2009年11月期间11例手指软组织肉瘤保指的患者,采取肿瘤广泛切除后,对创面覆盖选用第一掌背动脉皮瓣7例,第二掌背动脉皮瓣修复4例；其中5例合并肌腱缺损患者同期行肌腱移植修复,1例骨质缺损行髂骨移植术.结果术后6例接受新辅助化学治疗,1例接受辅助放射治疗.术后随访时间14个月至5年,9例肿瘤无复发,1例术后14个月肺转移死亡,1例肺转移带瘤生存.术后皮瓣全部存活,1例局部复发行截指.术后1年手指外观满意度为81％,功能评分为8～15分,平均12.6分,优或良10例,占91％.结论建议对手指软组织肉瘤有保指可能时应尽可能实施保指,并同期进行功能重建.
목적 회고성분석수지원발연조직육류병례,판단재근치종류적동시시부능실시보지이만족수지외관공능적수요.방법 수집2007년4월지2009년11월기간11례수지연조직육류보지적환자,채취종류엄범절제후,대창면복개선용제일장배동맥피판7례,제이장배동맥피판수복4례；기중5례합병기건결손환자동기행기건이식수복,1례골질결손행가골이식술.결과 술후6례접수신보조화학치료,1례접수보조방사치료.술후수방시간14개월지5년,9례종류무복발,1례술후14개월폐전이사망,1례폐전이대류생존.술후피판전부존활,1례국부복발행절지.술후1년수지외관만의도위81％,공능평분위8～15분,평균12.6분,우혹량10례,점91％.결론 건의대수지연조직육류유보지가능시응진가능실시보지,병동기진행공능중건.
Objective To retrospectively investigate the possibility of finger salvage after expiration of soft tissue sarcoma (STS).Methods Eleven patients diagnosed with STS had finger preserving procedures from April 2007 to November 2009.Following extended tumor resection,7 patients underwent first dorsal metacarpal artery flap transfer for soft tissue defect coverage while the second dorsal metacarpal artery flaps were employed for the others.Five patients needed autologous graft for tendon defects,and one patient needed autologous iliac bone graft.Results Six patients received adjuvant chemotherapy,while one patient received postoperative radiation therapy.Nine patients were alive and disease-free at a mean follow-up of 3 years (range,14 months to 5 years).One patient died of pulmonary metastasis 14 months after the surgery.Flap survival was 100％ and one patient (9％) had local complication.Nine flaps(81％) had excellent aesthetic results and the average functional score was 12.6 (range,8 to 15),representing excellent or good in 91％ of the patients.Conclusion Our study demonstrated that finger preservation in cases of soft tissue sarcoma can be achieved.We advocate one-stage reconstruction after tumor expiration instead of amputation.