Limb Sparing Surgical Resection of Groin Sarcoma. Surgical ... - NCI
Limb Sparing Surgical Resection of Groin Sarcoma. Surgical ... - NCI
Limb Sparing Surgical Resection of Groin Sarcoma. Surgical ... - NCI
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286flap without skin was used in 2 cases (Fig. 14).Sartorius muscle flap was used in 8 patients asit was included with the resection in 6 patients(Fig. 10).We had no flap failure or partial necrosis inall the flaps used.Complications:1- Seroma was the most frequent early complications(incidence 100%). The daily drainoutput ranged from 700 to 1900ml/day. Thiswas managed by prolonged drainage for 2weeks.2- Superficial stitch gaping occurred in 3 caseswhich healed completely within 2 weekswith repeated dressing.3- Wound breakdown and deep infection withexposure <strong>of</strong> the part <strong>of</strong> the underlying abdominalmesh was seen in one case (7%).This patient had previous radiotherapy andwas treated by removal <strong>of</strong> the mesh and thewound was left opened to granulate.4- Lymphedema. The most frequent late complication(35%) and was controlled by legelevation, massage and compression. It wasmild to moderate with no interference withwalking or climbing stairs.<strong>Limb</strong> salvage and limb function results:Over the 5 years study period, the extremitysalvage rate for patients present to us was 87.5%and included 14 patients out <strong>of</strong> 16 patients.<strong>Limb</strong> sparing radical resection was considered<strong>Limb</strong> <strong>Sparing</strong> <strong>Surgical</strong> <strong>Resection</strong> <strong>of</strong> <strong>Groin</strong> <strong>Sarcoma</strong>successful if the patients did not require amputationand have a functioning limb and the tumorwas resected without a residual. Removal <strong>of</strong>the pubic bone does not appear to have any longterm effects in ambulation. According to theMSTS function score, all patients achieved ahigh functional score ranging from 92% to 97%.Tumor control and survival: One patientrequired external hemipelvectomy after 23months postoperatively because <strong>of</strong> extensivelocal recurrence in the proximal thigh. The 2year local tumor control rate <strong>of</strong> those patients(minimal follow-up period) was 92.8% for 13/14patients. Two patients died because <strong>of</strong> extensivepulmonary metastasis after 24 and 26 months<strong>of</strong> surgery. The 2 year survival rate, the minimalfollow-up period, was 85.7% for 12/14 patients.Fig. (1): T1 MRI, showing the proximal extension <strong>of</strong> groins<strong>of</strong>t tissue sarcoma.Fig. (2): T1 MRI, showing the proximalextension <strong>of</strong> groin s<strong>of</strong>t tissuesarcoma.Fig. (3): T2 MRI, showing intrapelvicextension <strong>of</strong> groin sarcoma.Fig. (4): Preoperative angiographyshowing involvement <strong>of</strong> superfacialfemoral artery.