Microvascular reconstructions after extensive soft tissue sarcoma resections in the upper limb

Abstract

This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Methods: 20 patients with STS of the upper extremity were treated with excision and microvascular reconstruction. RT was administered if surgical margins were less than 25mm. M A N U S C R I P T A C C E P T E D ARTICLE IN PRESSResults were evaluated retrospectively.Results: 20 free flaps were performed and no flaps were lost. There was no operative mortality, and wound complication rate was 15%. Median follow-up length was 74 months.Five-year local recurrence-free survival was 57%, metastasis-free survival 67%, disease-free survival 45% and disease-specific overall survival 80%.

Therapeutic options and postoperative wound complications after extremity soft tissue sarcoma resection and postoperative external beam radiotherapy

“…Barner‐Rasmussen et al reviewed the STS database of Helsinki University central hospital in 2008 and extracted the data for 72 lower extremity cases that underwent microsurgical reconstruction and found a complication rate of 26%. Similarly, the same authors reviewed 20 upper extremity cases that underwent microsurgical reconstruction in 2010 and found a complication rate of 20% . The complications mentioned in the two studies were immediate reoperations for anastomotic revision, reoperations for haematoma and minor debridements …”

“…These patients generally had a higher risk profile for wound problems with larger tumours; unfavourable STS location; and exposure of vital structures such as tendons, nerves, bone or vessels . However, reported wound‐related morbidity rates were still satisfying and ranged from 13% to 30% . Spierer et al reported uncomplicated wound healing in all but one patient (4%), who required debridement before radiotherapy.…”

“…7 However, reported woundrelated morbidity rates were still satisfying and ranged from 13% to 30%. 15,33,47,51,52 Spierer et al 10 reported uncomplicated wound healing in all but one patient (4%), who required debridement before radiotherapy. Barner-Rasmussen et al 51 reviewed the STS database of Helsinki University central hospital in 2008 and extracted the data for 72 lower extremity cases that underwent microsurgical reconstruction and found a complication rate of 26%.…”

“…Similarly, the same authors reviewed 20 upper extremity cases that underwent microsurgical reconstruction in 2010 and found a complication rate of 20%. 52 The complications mentioned in the two studies were immediate reoperations for anastomotic revision, reoperations for haematoma and minor debridements. 51,52 Only two of the studies in this review reported higher complication rates in the patients treated by flaps opposed to patients treated by direct closure.…”

“…52 The complications mentioned in the two studies were immediate reoperations for anastomotic revision, reoperations for haematoma and minor debridements. 51,52 Only two of the studies in this review reported higher complication rates in the patients treated by flaps opposed to patients treated by direct closure. 35,53 Lohman et al 53 found complication rates of 38% in the flap group in comparison to 24% in the direct closure group.…”