Results of limb-salvage surgery with vascular reconstruction for soft tissue sarcoma in the lower extremity: comparison between only arterial and arterovenous reconstruction.
BACKGROUND
Reports on vascular reconstruction in conjunction with limb salvage techniques for soft tissue sarcomas in the lower extremity have been published. The aim of this study was to investigate the necessity for venous reconstruction by comparing the results of arterial reconstruction alone and those of arteriovenous reconstruction.


METHODS
Twenty-five (6.7%) of 373 patients underwent vascular resections for lower limb soft tissue sarcomas. Only arterial reconstruction was performed for 12 patients. Arteriovenous reconstruction was performed for 13 patients. The clinical results, complications, and postoperative function were compared between only arterial reconstruction group and arteriovenous reconstruction group.


RESULTS
Limb salvage was achieved in 92% of all cases. No local recurrence has been observed. Nineteen patients (76%) are continuously free of disease. Histopathologic examination of the specimens showed that blood vessels had been infiltrated in 24%. The mean Musculoskeletal Tumor Society score was 70%. There were no significant differences in complication rate and postoperative function between two groups.


CONCLUSIONS
Wide resection with vascular reconstruction for patients of soft tissue sarcomas involving major vessels in the lower limb provide long term local control and limb salvage. This study could not indicate the usefulness of additional venous reconstruction after vascular resection in the lower extremity.
Tsukushi
Satoshi
S
Department of Orthopaedic Surgery, Nagoya University Graduate School and School of Medicine, Nagoya City, Japan. s-tsuku@med.nagoya-u.ac.jp
Nishida
Yoshihiro
Y
Sugiura
Hideshi
H
Nakashima
Hiroatsu
H
Ishiguro
Naoki
N
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007866:Leg; D023821:Limb Salvage / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D019651:Plastic Surgery Procedures; D012189:Retrospective Studies; D012509:Sarcoma / Q000098:blood supply / Q000473:pathology / Q000601:surgery*; D012983:Soft Tissue Neoplasms / Q000098:blood supply / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome