105例胸壁肿瘤的诊断和外科治疗

目的：总结105例胸壁肿瘤的诊断和外科治疗经验,探讨胸壁大块缺损的重建方法.方法：回顾性总结分析105例胸壁肿瘤的临床资料.男78例,女27例.年龄6～70岁.94例原发性肿瘤,其中良性75例,恶性19例;11例为转移癌.19例行胸壁肿瘤切除及胸壁大块缺损重建术.结果：所有病例手术过程顺利,无手术死亡.术后随诊：48例良性肿瘤患者健在,16例死于其它原因.13例恶性肿瘤生存21个月至8年,恶性者术后主要死于复发及远处转移.11例转移癌全部死亡,术后生存10个月至6年4个月.结论：对无病理诊断的原发性肋骨肿瘤,应先做限制性根治切除术.大块胸壁缺损的重建,应用理想的修复材料是十分重要的.

Diagnosis and Surgical Treatment of 105 Cases with Tumors of the Chest Wall

Objective: To summarize the experience in diagnosis and surgical treatment of 105 cases with tumors of the chest wall,and to investigate reconstruction of a large chest wall defect after resection of chest wall tumors. Methods: Clinical data of 105 patients with tumors of the chest wall were retrospectively analyzed,among them 78 were males and 27 were females. Their ages ranged from 6 to 70 years. Of the 105 cases,94 were primary tumors among which 75 were benign tumor cases,19 were malignant and the remaining 11 were metastatic. Reconstruction of a large chest wall defect was conducted after a resection of the chest wall tumor in 19 patients. Results: All surgical operations were successfully performed,without intraoperative death. The results of postoperative follow-up were as follows: forty-eight patients with benign tumors were still living and healthy,16 patients with benign tumors died of other diseases,13 with malignant tumors survived for a period ranging from 21 months to 8 years,and the others with malignancy died of local recurrence or distant metastasis. All 11 patients with metastatic tumor died of carcinomatous diseases within 10 to 76 months. Conclusion: A restricted radical excision should be conducted first in cases of primary costal tumors without pathological diagnosis. Use of suitable repairing materials is very important for reconstruction of a large chest wall defect.