Festschrift for James S.T. Yao, MD, PhDConcomitant Arterial and Venous Reconstruction with Resection of Lower Extremity Sarcomas
Section snippets
Methods
During the period of 1991 to 2004, a total of 19 patients with primary bone and soft tissue sarcomas of the lower extremity underwent en block resection of tumor and involved artery and vein. The patient age, gender, tumor location, histologic tumor type, resected vessels, and graft material used are outlined in Table I. Nine of the patients 19 years of age or older were classified as adults; the remaining patients were considered children. At the time of initial evaluation, two patients had
Results
During the follow-up period (mean 5.7 years), three patients died of metastatic disease, and one died from a postoperative pulmonary embolism. Two of the patients with metastatic disease had known metastatic foci at the time of the initial operation done to control local disease; the other patient developed metastatic disease 1 year after the primary operation. Two of the patients had subsequent lung metastasectomies. None of the patients had local recurrence of their sarcoma. The average
Discussion
The results of this study are consistent with recent reports showing that treatment of lower extremity sarcoma with extended resection and vascular reconstruction can achieve both local disease control and limb salvage with good function. Perioperative multimodal therapy, including radiation treatment and chemotherapy, plays an important role in this process, reducing the incidence of local recurrence and metastasis.15 In our series, all patients received preoperative chemotherapy with seven
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2021, Journal of Plastic, Reconstructive and Aesthetic SurgeryLong-Term Outcomes of Rotationplasty patients in the treatment of lower extremity sarcomas with cost analysis
2020, Journal of Clinical Orthopaedics and TraumaCitation Excerpt :Many of these children require multiple additional surgeries for: early mechanical failure, limb lengthening, infection, aseptic loosening and other additional complications.9,11–16 As the surgical management in treating these patients have yet to be perfects, the authors desired to explore how rotationplasty patients, a limb salvage group familiar to our institution, fare after surgery in terms of overall functional status as well as quality of life and satisfaction after their diagnosis and management.10,17 This study was a retrospective, non-randomized, case study.
Giant Spontaneous Greater Saphenous Vein Aneurysm
2017, Annals of Vascular SurgeryVascular resection en-bloc with tumor removal and graft reconstruction is safe and effective in soft tissue sarcoma (STS) of the extremities and retroperitoneum
2016, Surgical OncologyCitation Excerpt :We confirm that the involvement of the vascular tree is not necessarily a contraindication for comprehensive surgical resection in STS [13,17,19–21]. Indeed STS located adjacent to or encasing major vessels presents a unique challenge to the operating surgeon, as microscopically positive resection margins are associated with a higher risk of LR and death [4,23–26]. In the present series R0 resection rate was achieved with this figure undoubtedly facilitated by resection of involved major vessels that would otherwise have necessitated and R1/R2 resection.