摘要
目的探讨腔镜手术治疗纤维脂肪血管性病变(FAVA)的可行性及安全性。方法回顾性分析西安国际医学中心医院2019年10月1日至2024年4月1日收治的腔镜治疗FAVA患者的临床资料,包括性别、发病年龄、诊断年龄、病变位置、手术时间、术中出血量、住院时间、切口并发症等。腔镜术前常规行MRI及超声检查,标记定位病变范围,依据不同病变部位选取手术体位及Trocar位置,在腔镜下手术切除病变组织。采用SPSS 26.0软件进行描述性统计分析。结果共纳入40例患者,其中男15例,女25例;发病年龄为8(6,12.5)岁;诊断年龄为11(8,22.5)岁。Ⅰ期31例,Ⅱ期9例;31例累及小腿,其中21例累及小腿三头肌(腓肠肌、比目鱼肌);9例累及大腿,其中1例病变起源于坐骨神经血管束周围筋膜。术中中转开放11例,占比27.5%。40例腔镜手术时间为192.5(107,292.5)min,术中出血量35(10,87.5)ml,住院时间9(7,11)d。术后随访11.5(3.5,13.5)个月,39例得以根治,术后无残留疼痛或者关节活动障碍;1例Ⅱ期患者术后踝关节背伸功能轻度受限。患者均未出现切口并发症及复发情况。结论对于Ⅰ、Ⅱ期FAVA患者进行腔镜手术治疗的切口隐蔽、瘢痕不明显,治疗效果确切,安全性高。
Objective To investigate the feasibility and safety of endoscopic surgery in the treatment of fibro-adipose vascular anomaly(FAVA).MethodsClinical data of FAVA patients who underwent endoscopic treatment admitted to Xi’an International Medical Center Hospital from October 1,2019 to April 1,2024 were retrospectively analyzed,including gender,age of onset,age of diagnosis,lesion location,operation time,intraoperative blood loss,hospital stays,incision complications,etc.Before endoscopy,magnetic resonance imaging and ultrasound were routinely used to locate the lesion range,and the surgical position and Trocar location were selected according to different lesion sites.Descriptive statistical analysis was conducted using SPSS version 26.0.Results40 cases of FAVA patients were admitted during the period,all of whom underwent endoscopic radical resection,including 15 males and 25 females.The age of onset was 8(6,12.5)years.The age of diagnosis was 11(8,22.5)years.There were 31 patients with stageⅠand 9 patients with stageⅡ.31 cases involved the calf,of which 21 involved the calf triceps(gastrocnemius,soleus)and 9 involved the thigh,of which 1 patient had lesions originating from the fascia around the sciatic neurovascular bundle.11 cases(27.5%)were converted to open surgery.The operative time was 192.5(107,292.5)min.The intraoperative blood loss was 35(10,87.5)ml.The length of hospital stay for endoscopic surgery was 9(7,11)d.The postoperative follow-up time was 11.5(3.5,13.5)months.Of the 40 patients,39 were cured completely without residual pain or joint movement disorder after operation.Postoperative dorsiflexion function of the ankle joint was mildly limited in one patient classified as stageⅡ.There was no incision complication and recurrence.ConclusionFor patients with stageⅠandⅡFAVA,endoscopic surgery has concealed incisions,indistinct scars,definite therapeutic effects and high safety.
作者
王培华
谢崇
王怀杰
郭正团
蔺卫龙
杨伟家
Wang Peihua;Xie Chong;Wang Huaijie;Guo Zhengtuan;Lin Weilong;Yang Weijia(Department of Pediatric Surgery and Vascular Anomalies,Xi’an International Medical Center Hospital,Xi’an 710100,China)
出处
《中华整形外科杂志》
北大核心
2025年第7期699-704,共6页
Chinese Journal of Plastic Surgery
基金
西安国际医学中心医院院级课题项目(2021QN016)。
关键词
血管瘤
脉管畸形
纤维脂肪血管性病变
腔镜
外科手术
Hemangioma
Vascular malformations
Fibro-adipose vascular anomaly
Endoscopic
Surgical procedures
