全腹外斜肌筋膜皮瓣下移修复肿瘤性腹股沟和下腹壁缺损

目的:介绍一种简单、安全有效的覆盖肿瘤切除后,腹股沟和下腹壁区缺损修复的新方法.方法:2005年9月～2007年12月,治疗4例患者.其中恶性纤维组织细胞瘤1例,纤维肉瘤1例,血管肉瘤1例,阴茎癌腹股沟淋巴结转移1例,全部病例均为多次手术后复发.切口起于腹股沟和下腹壁缺损区的内上角,沿中线走行至剑突后转向外上方,经由乳晕下方至腋后线.切开腹直肌前鞘的内缘,向外侧掀起腹直肌前鞘和续接的全腹外斜肌及其表面皮肤,形成具有宽大蒂部的肌筋膜皮瓣.然后,将皮瓣下移,覆盖在腹股沟和下腹壁缺损区.裸露的供区,利用皮肤和皮下组织的弹性,直接缝合.切除的范围从18×15～22×18cm,平均310cm<'2>.转位的肌筋膜皮瓣从30×17～37×20cm,肌筋膜皮瓣平均下移11cm以上.所有的创面均一期闭合,仅1例3×3cm区游离植皮.结果:4例转位的肌筋膜皮瓣全部成活,其中3例所有切口均一期愈合,1例下缘裂开,经换药愈合.平均随访11个月,复发1例.无腹壁疝出现.结论:应用全腹外斜肌筋膜皮瓣修复腹股沟区和下腹壁缺损,是一种简单,安全和有效的新方法.

Repair of the Groin and Low Abdominal Wall after Tumor Resection by Total Myofasciocutaneous Flap of Oblique External Abdominis Muscle Transposition

Objective: To introduce a simple, safe and effective method for coverage of the soft tissue defect of the groin and low abdominal wall. Methods: Four cases (3 males and 1 female), including 1 case of malignant fibrous histiocytoma, 1 case of fibrous sarcoma, 1 case of angiosarcoma and 1 case of inguinal lymph nodes metastasis of carcinoma of penis underwent multiple surgeries between September 2005 to December 2007. The average age was 69 (range 61-76). The surgical incision started from the medial upper co...