Objective: To explore the effectiveness of pedicled anterolateral thigh myocutaneous flap for full-thickness abdominal wall reconstruction after tumor resection.
Methods: Between September 2010 and December 2017, 18 patients with abdominal wall tumors were collected. There were 11 males and 7 females, with an average age of 45.2 years (range, 29-68 years). Histologic diagnosis included desmoid tumor in 8 cases, sarcomas in 6 cases, malignant teratoma in 2 cases, and colon adenocarcinoma in 2 cases. All abdominal wall defects were full-thickness defects. Peritoneum continuity was reconstructed with mesh; the lateral vastus muscular flaps were used to fill the dead space and rebuild the abdominal wall strength; the abdominal wall soft tissue defects were repaired with pedicled anterolateral thigh flaps. The size of abdominal wall defects ranged from 15 cm×6 cm to 25 cm×22 cm; the size of lateral vastus muscular flap ranged from 10 cm×8 cm to 22 cm×10 cm; the size of anterolateral thigh flap ranged from 14.0 cm×8.0 cm to 21.0 cm×8.5 cm. The bilateral pedicled anterolateral thigh myocutaneous flaps were harvested to repair the extensive abdominal wall defects in 2 cases. All donor sites were sutured directly.
Results: All wounds healed smoothly and all flaps survived totally. All donor sites healed smoothly. The mean follow-up time was 22.5 months (range, 11-56 months). No tumor recurrence occurred, the abdominal function and appearance were satisfactory, no abdominal hernia was noted. Only linear scar left at the donor sites.
Conclusion: Pedicled anterolateral thigh myocutaneous flap combined with mesh is fit for large full-thickness abdominal defect reconstruction.
目的: 探讨带蒂股前外侧肌皮瓣修复腹壁肿瘤术后全层缺损的疗效。.
方法: 2010 年 9 月—2017 年 12 月,收治 18 例腹壁肿瘤患者。男 11 例,女 7 例;年龄 29~68 岁,平均 45.2 岁。原发疾病:腹壁纤维瘤 8 例,肉瘤 6 例,结肠腺癌腹壁转移 2 例,恶性畸胎瘤 2 例。手术彻底切除肿瘤,遗留全层腹壁缺损范围为 15 cm×6 cm~25 cm×22 cm;采用网片固定重建腹膜连续性,带蒂股前外侧肌皮瓣填充腔隙及修复皮肤软组织缺损;其中股外侧肌瓣切取范围为 10 cm×8 cm~22 cm×10 cm,股前外侧皮瓣为 14.0 cm×8.0 cm~21.0 cm×8.5 cm。其中 2 例大面积缺损采用双侧带蒂股前外侧肌皮瓣修复。供区均直接拉拢缝合。.
结果: 术后所有皮瓣顺利成活,创面Ⅰ期愈合;供区切口Ⅰ期愈合。患者均获随访,随访时间 11~56 个月,平均 22.5 个月。随访期间均无肿瘤复发,未见腹壁疝表现,皮瓣外观及腹部功能均满意。.
结论: 带蒂股前外侧肌皮瓣结合网片适用于修复腹壁肿瘤术后全层缺损。.
Keywords: Abdominal wall defect; abdominal wall tumor; anterolateral thigh myocutaneous flap; pedicled flap; wound repair.