title: Reconstruction of Complex Groin Defects After Sarcoma Resection.
abstract: BACKGROUND
  Complex groin defects after sarcoma resection require reconstruction of multiple vital structures that can include the major vessels, the overlying skin, the abdominal wall, and the hip joint. We investigated the feasibility of limb preservation after complex groin reconstruction.
  
  
  METHODS
  The subjects were 12 consecutive patients who underwent complex groin reconstruction after sarcoma resection. In all patients, the defect included a major artery (external iliac or femoral) and overlying skin. The defect included the abdominal wall in 5 patients and the hip joint in 2. Arterial reconstruction was performed with an autologous vein graft in 9 patients and with an expanded polytetrafluoroethylene graft in 3. Soft-tissue coverage was performed with a pedicled rectus abdominis musculocutaneous flap in 7 patients, a free latissimus dorsi musculocutaneous flap in three, and a free anterolateral thigh flap in 2.
  
  
  RESULTS
  Postoperative complications occurred in 7 patients (58.3%). Limb salvage was possible in 8 patients (66.7%) with 39 months' median follow-up. Two patients required amputation because of wound problems, and 2 required amputation because of local recurrence of the tumor.
  
  
  CONCLUSIONS
  Limb salvage is possible even after extensive resection of groin sarcoma, although the rate of postoperative wound complications is substantial. Proper selection of the arterial conduit and the soft-tissue flap, depending on the components of the defect, are mandatory for successful reconstruction.
authors.affiliation: From the *Department of Plastic and Reconstructive Surgery, and †Department of Musculoskeletal Oncology, National Cancer Center Hospital, Tokyo; ‡Department of Plastic and Reconstructive Surgery, National Cancer Center Hospital East, Kashiwa, Japan.
authors.forename: Shimpei
authors.initials: S
authors.lastname: Miyamoto
authors.forename: Masahide
authors.initials: M
authors.lastname: Fujiki
authors.forename: Fumihiko
authors.initials: F
authors.lastname: Nakatani
authors.forename: Eisuke
authors.initials: E
authors.lastname: Kobayashi
authors.forename: Masanobu
authors.initials: M
authors.lastname: Sakisaka
authors.forename: Minoru
authors.initials: M
authors.lastname: Sakuraba
mesh_terms: D000328:Adult; D000368:Aged; D001859:Bone Neoplasms / Q000473:pathology / Q000601:surgery*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D006119:Groin / Q000473:pathology / Q000601:surgery*; D006801:Humans; D023821:Limb Salvage / Q000379:methods; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D018570:Risk Assessment; D012509:Sarcoma / Q000473:pathology / Q000601:surgery*; D013524:Surgical Flaps / Q000098:blood supply / Q000637:transplantation*; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology; D055815:Young Adult