Revascularization after segmental resection of lower extremity soft tissue sarcomas.
OBJECTIVE
Limb salvage surgery combined with vascular reconstruction has replaced amputation as the preferred treatment of soft tissue sarcomas involving major vascular structures of the extremities. We describe our experience with soft tissue sarcomas involving major vascular structures and examine outcomes according to the type of graft selected for arterial reconstruction. We also examine the effect of venous reconstruction on post-operative edema.


METHODS
This retrospective review includes 14 patients with lower extremity soft-tissue sarcomas that encased major vessels, requiring combined limb-preserving tumor resection and revascularization with a synthetic or autogenous saphenous vein graft. Edema in patients with and without venous reconstruction was compared. The incidence of infection, wound dehiscence, and graft thrombosis were compared according to arterial graft type.


RESULTS
There was no significant difference in edema in patients with venous reconstruction and those without. There was also no significant difference in infection and graft thrombosis in patients with synthetic grafts and those with autogenous saphenous vein grafts. Wound dehiscence occurred more often in patients with synthetic grafts (P = 0.029).


CONCLUSIONS
Although this study was small, these results suggest that further studies are needed to determine the roles that vascular graft selection and venous reconstruction play in clinical outcome.
Adelani
Muyibat A
MA
Department of Orthopaedics and Rehabilitation, Vanderbilt University School of Medicine, Nashville, Tennessee, USA.
Holt
Ginger E
GE
Dittus
Robert S
RS
Passman
Marc A
MA
Schwartz
Herbert S
HS
D000293:Adolescent; D000328:Adult; D000368:Aged; D000671:Amputation, Surgical; D019917:Blood Vessel Prosthesis Implantation; D015331:Cohort Studies; D005260:Female; D006801:Humans; D023821:Limb Salvage / Q000379:methods; D008080:Liposarcoma / Q000098:blood supply / Q000601:surgery; D035002:Lower Extremity / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods; D012189:Retrospective Studies; D012501:Saphenous Vein / Q000637:transplantation*; D012509:Sarcoma / Q000098:blood supply / Q000473:pathology / Q000601:surgery*; D012983:Soft Tissue Neoplasms / Q000098:blood supply / Q000473:pathology / Q000601:surgery*; D013529:Surgical Wound Dehiscence / Q000209:etiology; D013848:Thigh / Q000098:blood supply; D016896:Treatment Outcome