The "AISS" strategy for giant neurofibroma in the trunk
10.3760/cma.j.cn114453-20231105-00188
- VernacularTitle:遵循"AISS"策略精准治疗躯干部巨大神经纤维瘤
- Author:
Fan ZHANG
1
;
Shangxiong CHEN
;
Bin ZHANG
;
Jiaping ZHANG
Author Information
1. 陆军军医大学第一附属医院整形外科，重庆 400038
- Keywords:
Neurofibroma;
Neurofibromatoses;
Giant neurofibroma;
"AISS"strategy;
Precise treatment
- From:
Chinese Journal of Plastic Surgery
2024;40(2):179-186
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the surgical strategy for giant neurofibromas in the trunk with the goal of precise treatment of superficial tumors.Methods:We retrospectively analyzed the patients with giant neurofibroma of the trunk who admitted to the Department of Plastic Surgery, Southwest Hospital of Army Medical University from January 2021 to March 2023. All patients were treated with "AISS" strategy: (1) autologous blood storage; (2) interventional embolization of the key blood supply artery of the tumor; (3) surgical resection of the tumor; (4) skin graft was harvested from the tumor to repair the secondary defect. Patient demographics, autologous blood storage volume, specific blood vessels and methods of interventional embolization, intraoperative blood loss, intraoperative blood transfusion, complications, and tumor recurrence at follow-ups were documented.Results:A total of 5 patients were enrolled, including 4 males and 1 female, aged 22-32 years. The tumors size ranged from 21 cm×20 cm to 76 cm×66 cm, which were located in the trunk (neck, chest, waist, sacrococcygeal region). The volume of autologous blood storage ranged from 800 to 1 600 ml before the operation. The main blood supply vessels of the tumor were embolized before the operation, including: internal thoracic artery, intercostal artery, external thoracic artery, lumbar artery, inferior epigastric artery, iliolumbar artery and internal iliac artery. All patients underwent radical resection. The intraoperative blood loss was 150-3 000 ml. Patients were transfused with their autologous blood during the operation. There were no severe intraoperative hemorrhage, adverse effects of blood transfusion or infection were not noted. A small skin graft necrosis was noticed in the bilateral iliac fossa in one patient, which was subsequently resolved through dressing change and blade-thickness skin graft transplantation. No tumor recurrence was found during the follow-up period (6-24 months).Conclusion:"AISS" strategy not only safely and accurately treat giant neurofibroma of trunk, but also effectively reduce the intraoperative blood loss and complications, repair of huge wounds in one stage, preventing the recurrence rate of tumors and improving patient satisfaction.
