[Surgical management of soft tissue sarcomas: principles of resection and reconstructive plastic procedures].
1. Adequate complete surgical resection with a oncologic radical or wide margin of normal tissue represents the most important measure to prevent a local recurrence. Limited excision with "shelling-out" of the tumor, through its "pseudocapsule" almost invariably means positive microscopic margins. The pathohistologically or macroscopically marginal or intralesional positive resection margins make a salvage surgery necessary. 2. A close safety margin of < 1 cm due to neighboured anatomic structures indicates a high risk of local recurrence and makes an adjuvant radiotherapy mandatory. Plastic-reconstructive surgery should prepare the radiotherapy fields, to avoid cavities or ulcerations. 3. Facts should be stated in the clinical record and the operation report, e.g. the safety margin should be defined by the surgeon and the pathologist; the histopathologic stage and grade are absolutely basic requirements. If necessary, a second histopathologic review should be asked for. 4. Tumor resection and reconstructive oncoplastic measures should correspond individually to the oncologic parameters, to the functional demands and to the age of the patient. 5. Multidisciplinary cooperation in a tumorboard is a precondition for an adequate treatment.
Klinik für Plastische Chirurgie und Schwerbrandverletzte, Universitätsklinik Bergmannsheil, Bochum.
H U
HU
Steinau
D
D
Hebebrand
A
A
Torres
P
P
Vogt
D006801:Humans; D019651:Plastic Surgery Procedures / Q000379:methods* / Q000639:trends; D012509:Sarcoma / Q000534:rehabilitation* / Q000601:surgery*; D012983:Soft Tissue Neoplasms / Q000534:rehabilitation* / Q000601:surgery*; D013518:Surgery, Plastic / Q000379:methods* / Q000639:trends; D013709:Tendon Transfer / Q000379:methods / Q000639:trends
Weichgewebssarkome: Resektionsprinzipien und Wiederherstellungschirurgie.