Изучение причин возникновения рецидивов бластом мягких тканей
заслуживает особого внимания, так как позволяет найти рациональные пути для их
предупреждения. Возможные факторы могут быть разделены на две группы: 1)
местные факторы, зависящие от степени распространенности процесса; 2) ошибки и
неудачи проведенного лечения, в первую очередь при выполнении операции удаления
или иссечения первичного очага.
Как уже подчеркивалось, доминирующее значение в возникновении
рецидивов имеет стадия заболевания, отражающая степень распространения опухоли.
При пятилетнем сроке наблюдения частота рецидивов в III стадии превышает данные
для I стадии в три раза.
Несомненное значение для возникновения рецидива имеют ошибки и
неудачи проведенной ампутации конечности, обусловленные неправильным выбором ее
уровня. Среди возможных факторов встречаются повреждение целостности первичной
опухоли, угрожающее диссеминацией опухолевых элементов по ране и появлением
множественных имплантационных узелков в рубце и прилежащих участках кожи.
Нарушение абластики происходит гораздо чаще, чем это предполагают сами хирурги
(А. И. Раков, 1968). Поэтому использование электроножа уменьшает опасность
диссеминации и понижает частоту рецидивов (Н. Н. Петров, 1947; Б. А. Рудявский,
1957; Т. А. Аббасов, 1967; А. И. Ошмянская, 1973, и др.).
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