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

Abstract

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