Clinical Characteristics and Surgical Outcomes of Limb-Sparing Surgery with Vascular Reconstruction for Soft Tissue Sarcomas

Çetinkaya, Ömer Arda; Çelik, Süleyman Utku; Kalem, Mahmut; Başarır, Kerem; Köksoy, Cüneyt; Yıldız, Hüseyin Yusuf

doi:10.1016/j.avsg.2018.09.018

Cited by 8 publications

(8 citation statements)

References 24 publications

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“…(2,7,11) ( Tab 1) No infection were observed in our experience. In this condition, when the vessel involvement and removal is crucial for a radical surgery, vascular surgeon role is essential in a multidisciplinary setting, also to choice the better technique of revascularization or to decide no indication for an eventual venous vessel replacement (12,13) (Fig 3-4) In particular cases the removal of the neoplasm may require a large dissection to preserve the vascular axis and also in the absence of a revascularization, the presence of the vascular surgeon makes the bleeding minimal and the removal more accurate and, at the same time, radical. ( Fig 2B).…”

Section: Results and Complicationmentioning

confidence: 99%

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Strategy to preserve function in lower limbs tumors resection. Vascular competence in multidisciplinary approach

Marchetti

Giulio

Oddi

et al. 2020

Preprint

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IntroductionAll possible strategy should be adopted to preserve limb function during the definitive removal operation in the case of limbs sarcoma. Multidisciplinary perspective seems to be the ideal choice. The aim of the study is to report our experience gained in collaboration with the IFO oncology orthopedic division and with the operating units of Orthopedics A and B of our institution, reporting the type of intervention, results and complications of the procedures performed.Material and methodsFrom 2011 to 2019, were treated 32 patients affected by primitive and secondary musculoskeletal neoplasm with a mean age of 44 years (14-67 years) in 28 cases (87.5%) were required revascularization. Women accounted for 46.9% (15/32), 53.1% were men (17/32). The preoperative study included a biopsy of the lesion and ultrasonography and CTA with multiplanar reconstructions for the evaluation of the vascular anatomy and neoplasia extension.ResultsThe average postoperative follow-up was 20.1 months. The reconstruction of the vessels has been implemented in 14/32 (43.7%) mainly using the autologous saphenous contralateral vein. The use of the prosthesis was performed in the others cases (with PTFE and Dacron K prosthesis). In 5 cases (15.6%) the patients had lower limb edema, with a distance venous patency of 26/32 (81.2%) and arterial patency of 100%. We had no mortality at 30 days. Two patients underwent VAC therapy. No amputations were performed at 30 days. In 14 patients was performed perioperative chemotherapy or radiotherapy.ConclusionsA long-term evaluation is needed to determine the implications at distance, in patients undergoing radical resection of cancer in which are necessary for skills vascular surgery. The long term result is conditioned by the prognosis of neoplasm. The multidisciplinary approach is always requested.

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Section: Results and Complicationmentioning

confidence: 99%

“…The 5-year survival rate is 68.4% in the more prolonged follow up. (12,14) As in reconstructions for atherosclerotic obstructive pathology, the vein is used as an ideal substitute.…”

Section: Results and Complicationmentioning

confidence: 99%

Strategy to preserve function in lower limbs tumors resection. Vascular competence in multidisciplinary approach

Marchetti

Giulio

Oddi

et al. 2020

Preprint

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“…No infections were observed in our experience Table 1. A multidisciplinary setting is crucial for the radicality of the surgery [12][13][14][15] (Figures 1-2).…”

Section: Journal Of Surgery and Research 149mentioning

confidence: 99%

“…The majority of patients need chemo and radiotherapy and despite the good immediate results in terms of mortality, during the follow up the appearance of metastases and consequent mortality is not negligible. In a long time follow-up experience of 105 months, the 5-year survival rate reported is 68.4% [15][16]. For vessels reconstructions the vein is considered ideal substitute for neoplasm and for atherosclerotic obstructive pathology.…”

Section: Journal Of Surgery and Research 150mentioning

confidence: 99%

Oncovascular Surgery-The Multidisciplinary Approach: Surgical Resection of the Musculoskeletal Tumor and Associated Revascularization

Andrea¹,

Lorenzo²,

Citoni³

et al. 2019

J Surg Res

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Introduction: The possibility of preserving the limb during the definitive removal operation in the case of sarcoma is a goal pursued in a multidisciplinary perspective. The aim of the study is to report our experience gained in collaboration with the IFO oncology orthopedic division and with the operating units of Orthopedics A and B of the Tor Vergata Policlinico, reporting the results and complications of the procedures performed. Methods: From 2011 to 2014, 30 patients treated had primitive and secondary musculoskeletal neoplasm with a mean age of 44 years (14-67 years) in 26 cases (86.6%) were required revascularization. Women accounted for 53.84% (14/26), 46.16% were men (12/26). The preoperative study included a biopsy of the lesion and ultrasonography and angio-CT with multiplanar reconstructions for the evaluation of the vascular anatomy and neoplasia extension. Results: The average postoperative follow-up was 19.4 months. The reconstruction of the vessels has been implemented in 12/26 (46%) mainly using the autologous saphenous contralateral vein. The use of the prosthesis was performed in the others cases (with PTFE and Dacron K prosthesis). In 4 cases the patients had lower limb edema, with a distance venous patency of 80% and arterial patency of 100%. We had no mortality at 30 days. Two patients underwent VAC therapy. No amputations had at 30 days. In 14 patients were perform chemotherapy or radiotherapy before and after surgery. Conclusions: A long-term evaluation is needed to determine the implications at distance. In case of involvement of

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“…Soft tissue mass of leg usually invades adjacent vessels and nerves. 1,2 Computed tomography angiography (CTA) is the rst-line test in revealing arterial invasion by tumor. 2 Magnetic resonance angiography (MRA) serves as an alternative to CTA.…”

Section: Introductionmentioning

confidence: 99%

Readout-segmented diffusion tensor imaging for assessing sciatic nerve invasion by soft tissue tumor

Wan¹,

Wang²,

Chu³

et al. 2020

Preprint

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There are few publications regarding feasibility of readout-segmented diffusion tensor imaging (rsDTI) in assessing nerve invasion by soft tissue tumor. 64 patients with soft tissue mass in upper leg suspected of sciatic nerve invasion underwent rsDTI. Nerve invasion was confirmed in 28 cases by operation or electromyogram. The sciatic nerve was better depicted with diffusion weighted map versus b = 0 map of rsDTI. Inter-reader agreement in using rsDTI to rate nerve invasion was excellent. Sensitivity and specificity of rsDTI in identifying nerve invasion were 93% (26/28) and 92% (33/36) respectively. Apparent diffusion coefficient (ADC) was significantly higher in invaded nerves versus normal nerves (1.45 ± 0.67 × 10− 3mm2/s vs. 1.39 ± 0.46 × 10− 3mm2/s, P༜0.05). DTI derived FA was significantly lower in invaded nerves versus normal nerves (0.22 ± 0.11 vs. 0.37 ± 0.13, P༜0.05). Readout-segmented DTI was feasible in assessing sciatic nerve invasion by soft tissue tumor in selected patients.

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Clinical Characteristics and Surgical Outcomes of Limb-Sparing Surgery with Vascular Reconstruction for Soft Tissue Sarcomas

Cited by 8 publications

References 24 publications

Strategy to preserve function in lower limbs tumors resection. Vascular competence in multidisciplinary approach

Strategy to preserve function in lower limbs tumors resection. Vascular competence in multidisciplinary approach

Oncovascular Surgery-The Multidisciplinary Approach: Surgical Resection of the Musculoskeletal Tumor and Associated Revascularization

Readout-segmented diffusion tensor imaging for assessing sciatic nerve invasion by soft tissue tumor

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