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 of the part of the underlying abdominalmesh was seen in one case (7%).This patient had previous radiotherapy andwas treated by removal of 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.Limb 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 of 16 patients.Limb sparing radical resection was consideredLimb Sparing Surgical Resection of Groin Sarcomasuccessful if the patients did not require amputationand have a functioning limb and the tumorwas resected without a residual. Removal ofthe 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 of extensivelocal recurrence in the proximal thigh. The 2year local tumor control rate of those patients(minimal follow-up period) was 92.8% for 13/14patients. Two patients died because of extensivepulmonary metastasis after 24 and 26 monthsof 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 of groinsoft tissue sarcoma.Fig. (2): T1 MRI, showing the proximalextension of groin soft tissuesarcoma.Fig. (3): T2 MRI, showing intrapelvicextension of groin sarcoma.Fig. (4): Preoperative angiographyshowing involvement of superfacialfemoral artery.
Magdy El-Sherbiny 287Fig. (5): Improper transverse incision with incompleteresection.Fig. (6): Defect after resection of groin sarcoma.Note, femoral vessels, spermatic cordand proline mesh for reconstruction ofabdominal wall defect.Fig. (7): Rectus abdomins myocutaneous flap for coverage of longitudinalgroin and thigh defect after resection of groin softtissue sarcoma.Fig. (8): Rectus abdomins myocutaneous flapfor coverage of transverse defect afterresection of groin soft tissue sarcoma.Fig. (9): Gracilis myocutaneous flap for reconstruction ofgroin defect after resection of groin soft tissuesarcoma.Fig. (10): Gracilis myocutaneous flap for reconstructionof groin defect after resectionof groin sof tissue sarcoma.
Page 2: 282A high percentage of patients ha
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Page 12 and 13: 292REFERENCES1- Brooks AD, Bowne WB

Limb Sparing Surgical Resection of Groin Sarcoma. Surgical ... - NCI

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