摘要
目的探讨扩大切除术结合Mohs显微描记手术(简称Mohs手术)治疗隆突性皮肤纤维肉瘤(dermatofi brosarcoma protuberans,DFSP)的方法及疗效。方法 2007年1月-2010年1月,收治17例DFSP患者。男9例,女8例;年龄16～55岁,平均33.2岁。头颈部2例,躯干12例,四肢2例,会阴部1例。初发6例,复发11例。病灶为单个或多个结节,部分结节融合,结节中央隆起可见皮肤萎缩、瘢痕或斑块,边缘不清。病灶直径为0.8～9.7 cm,平均4.3 cm。无远处转移或淋巴结转移。行扩大切除术结合Mohs手术彻底切除肿瘤后,采用直接拉拢缝合(3例)、游离植皮(9例)及皮瓣移位(5例)修复创面。结果扩大切除术后行Mohs切除1次13例,2次3例,3次1例。手术时间56～219 min,平均98.6 min。术后植皮及皮瓣均顺利成活,切口Ⅰ期愈合。供区植皮均成活,切口Ⅰ期愈合。患者均获随访,随访时间8～34个月,平均21.7个月。皮瓣色泽、质地与受区相似,外观良好。患者随访期间均无复发。结论扩大切除术结合Mohs手术治疗DFSP具有手术时间较短、肿瘤切除彻底及周围正常皮肤损伤小等优点。
Objective To investigate the method and effectiveness of wide local excision combined with Mohs micrographic surgery for dermatofibrosarcoma protuberans（DFSP）.Methods Between January 2007 and January 2010,17 patients with DFSP were treated.There were 9 males and 8 females with an average age of 33.2 years（range,16-55 years）.The lesions were located at head and neck（2 cases）,trunk（12 cases）,extremity（2 cases）,and perineal region（1 case）.There were 6 cases of primary DFSP and 11 cases of relapsed DFSP.The lesions presented as single or multitude nodules or fusion nodules with skin withering,scar,en plaque in the center and with ill-defined margins.The diameter of lesions ranged from 0.8 to 9.7 cm（mean,4.3 cm）.No distant metastasis or lymphatic metastasis occurred in all cases.After tumors resection by wide local excision combined with Mohs micrographic surgery,the wounds were repaired by direct suture in 3 patients,skin grafting in 9 patients,and local skin flap in 5 patients.Results Wide local excision and Mohs micrographic surgery were carried out once in 13 patients,twice in 3 patients,and three times in 1 patient with an average operation time of 98.6 minutes（range,56-219 minutes）.Primary healing of wound and donor site were achieved with no necrosis of skin grafting and skin flap.All patients were followed up 8-34 months（mean,21.7 months） with no recurrence.Conclusion Wide local excision combined with Mohs micrographic surgery could treat DFSP,which has the advantages of shorter operation time,radical resection,and less injury.
出处
《中国修复重建外科杂志》
CAS
CSCD
北大核心
2011年第11期1350-1353,共4页
Chinese Journal of Reparative and Reconstructive Surgery
