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KMID : 0358820090360040511
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Journal of Korean Society of Plastic and Reconstructive Surgeons
2009 Volume.36 No. 4 p.511 ~ p.514
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Giant Neurofibroma on Both Buttocks
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Kim Ji-Hoon
Kim Hyung-Kyung
Burm Jin-Sik
Kim Yang-Woo
Kang So-Ra
Kim Hyung-Kyung
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Abstract
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Purpose: Neurofibromatosis(NF) is an autosomal- dominant systemic disease. Up to fifty percent of patients with NF are reported to have concomitant vascular abnormalities. In the resection of a larger NF, the risk of uncontrolled hemorrhage is much higher due to the difficulty of hemostasis of large vessels within the tumor. We ligated the base of the giant NF with a simple loop- shaped ligation before removal of the giant NF in both buttocks. And then we successfully reduced the amount of hemorrhage during the operation.
Methods: A 46-year-old female patient presented for giant masses of both gluteal area, which has been growing slowly for the last ten years. Each mass was about 30×20 cm in size. After designing the elliptical resection margin, we tightened the tumor base by using continuous loop- shaped suture ligation(weaving the thread up and down in a loop-shaped pattern, leaving a space of 2cm between each loop) with a straight needle and prolene 2-0. After skin incision, we proceeded the dissection toward the central and inferior side of the mass obliquely while we avoided breaking large vascular sinuses. We resected the tumor in a wedged-shape. Subcutaneous tissue was sutured layer by layer and skin was closed by vertical mattress and interrupted suture. The loop-shaped ligation of the base was removed and compressive dressing was done with gauzes and elastic bandages. Received March 31, 2009 Revised May 6, 2009 Accepted May 20, 209 Address Correspondence: Jin Sik Burm, M.D., Department of Plastic and Reconstructive Surgery, Ewha Womans University Medical School, 911-1 Mok-dong, Yangcheon-gu, Seoul 158-710, Korea. Tel: 02) 2650-5149/Fax: 02) 2651-9821/ E-mail: jsburm@ewha.ac.kr *본 논문은 제 62 차 대한성형외과학회 춘계 학술 대회에서 포스터 발표되었음.
Results: Postoperative complications such as infection, hemorrhage, hematoma, and dehiscence did not occur. Perioperatively the patient was sufficiently transfused with five units of blood and two units of fresh frozen plasma. During the subsequent 1 year follow-up, the functional and cosmetic results were excellent.
Conclusion: A continuous loop-shaped suture ligation procedure along the base of the giant NF effectively reduced the amount of hemorrhage during the operation, made dissection and ligation of vessels easily and quickly, and shorten the operating time and postoperative recovery time.
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KEYWORD
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Giant Neurofibroma, Buttock, Suture Ligation, Excision
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