To Explore Special Issues In Surgical Treatment Of The Buttock Soft Tissue Sarcoma

Objective:The purpose of this study was to explore the surgical border, suigical technique and prevention of the complication in the buttock soft tissue sarcoma,through dissecting the buttock and surgical practice. Methods:(1)The gluteal fascia,composition of the wall of the subgluteus maximus space, superior gluteal artery and sciatic nerve of the pelvic extius were observed on the six specimen. (2)This retrospective study included seven cases with soft tissue sarcoma of the buttock were treated surgically from August 2006 to July 2009. Patients'age ranged from 7 to 55 years old (mean 35. 7 years), including of 5 male and 2 female.Out of the patients, there were two sarcoma epithelioides, two myxoid liposarcomas, one fibrosarcoma, one malignant fibrohistioytoma, one synovial sarcoma. The maximum diameter of each lesion ranged from 10 to 15 centimeters. 4 cases were performed barrier resection and 3 cases marginal resection. Results:Applicable anatomy (1) The muscle, tendon, ligaments and fascia on the subgluteus maximus space have barrier fuction for the soft tissue sarcoma of the buttock. (2)The gluteal artery on the pelvic extius is't liberation, with surrouding by the fibrous connective tissue on the greater sciatic formaen inside 1cm. (3)There is a space between sciatic nerve and infrapiriform foramen, and the surface of sciatic nerve have a layer adipose tissue. Clinical:Seven cases were followed up from 6-36 months, average 24 months.Six patients were free of disease and one patient died because of pulmonary metastasis. Conclusions:(1)Barrier resection is an ideal method for the soft tissue sarcoma of the buttock. (2)By enlargement of the greater sciatic notch, we resected soft tissue sarcoma which intruded into pelvic cavity through greater sciatic foramen in order to avoid tumor residue in the pelvic cavity.