侵犯下肢主要血管恶性肿瘤的保肢手术治疗

目的 :探讨肿瘤侵犯下肢主要血管的保肢手术治疗。方法 :将受肿瘤侵犯 ,无法解剖出来的血管作节段切除以彻底切除肿瘤 ,然后以直接吻合或进行血管移植桥接来重建下肢血循环以达到保肢目的。涉及髂血管节段切除和股血管节段切除各 2例。切除后血管的重建 ,动脉采用直接吻合 1例次 ,以自体大隐静脉倒置移植重建 2例次 ;静脉以自体大隐静脉移植重建 2例次。结果 :4例病人获保肢切除后随访 10个月～ 4年 ,患肢无疼痛和肿胀。结论 :肿瘤侵犯了下肢主要血管 ,采用血管重建技术 ,仍可进行保肢手术治疗 ,使病人术后的生活质量优于截肢

Limb Salvage Operations for the Malignancies Involved the Major Vessels of Lower Extremities

Objective To explore preferable method of treatment to amputate for malignancies with involvement of major vessels of the lower extremities.Methods Complete tumor removal with segmental resection of the involved vessels and vascular reconstruction techniques were used to achieve limb salvage.The resection involved both the iliac vessels and the femoral vessels in two cases.Arterial reconstruction was performed with anastomosis in one case and with a reversed autologous greater saphenous vein graft in two cases.Venous reconstruction was performed with autologous greater saphenous vein graft in two cases.Results Of four patients underwent limb salvage operation,none had edema and pain in the lower extremities in a follow up period ranging from 10 to 48 months.Conclusions Limb salvage,which may preserve life quality,may be achieved with application of vascular reconstruction techniques for malignancies with involvement of major vessels of the lower extremity.