scholarly journals Free Functional Latissimus Dorsi Reconstruction of the Quadriceps and Hamstrings following Oncologic Resection of Soft Tissue Sarcomas of the Thigh

Sarcoma ◽  
2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Matthew T. Houdek ◽  
Elizabeth P. Wellings ◽  
Katherine E. Mallett ◽  
Rachel L. Honig ◽  
Peter S. Rose ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Sarcomas ◽  
Primary Treatment ◽  
Limb Salvage Surgery ◽  
Delayed Wound Healing ◽  
Volumetric Muscle Loss ◽  
High Incidence ◽  
The Mean ◽  
Muscle Groups ◽  
And Function

Background. Limb-salvage surgery combined with radiotherapy has become the primary treatment for soft tissue sarcomas of the extremity. Free functional latissimus flaps (FFLF) are an option to restore function in the setting of volumetric muscle loss. The purpose of the current study was to examine the use of FFLF in patients undergoing resection of thigh sarcoma. Methods. Twelve patients with a sarcoma involving the hamstring (n = 6), quadriceps (n = 5), or combined (n = 1) defects which included multiple muscle groups were reviewed. This included 9 males and 3 females with a mean age and body mass index of 56 ± 12 years and 31.3 ± 5.7 kg/m2. Results. The mean defect volume and operative time was 3,689 ± 2,314 cm3 and 587 ± 73 minutes. Following reconstruction, the mean knee range of motion (ROM), MSTS93 score, and muscle strength was 89 ± 24°, 90 ± 15%, and 4 ± 1; with 75% of patients ambulating without gait aids. Seven (58%) patients sustained a complication, namely, delayed wound healing (n = 2). Conclusion. Although there was a high incidence of complications, FFLF can restore active knee ROM and function, with most patients ambulating without gait aids following reconstruction of large oncologic defects in the thigh.

LOCAL RECURRENCES AFTER THE TREATMENT OF SOFT TISSUE MALIGNANT FIBROUS HISTIOCYTOMA (UNCLASSIFIEDPLEOMORPHIC SARCOMA) OF THE LIMBS

2019 ◽  
Vol 72 (8) ◽  
pp. 1523-1526
Author(s):  
Oleksandr O. Lytvynenko ◽  
Volodymyr F. Konovalenko ◽  
Anton Yu. Ryzhov
Keyword(s):  
Soft Tissue ◽  
Malignant Fibrous Histiocytoma ◽  
Fibrous Histiocytoma ◽  
Survival Rates ◽  
Soft Tissue Sarcomas ◽  
Primary Treatment ◽  
Radical Excision ◽  
Local Recurrences ◽  
Results Of Treatment

Introduction: The treatment of patients with malignant fibrous histiocytoma as well as other soft tissue sarcomas is not sufficiently effective up to date, and has largely changed and reflects the alterations, occurred in oncology as a whole. The number of amputation decreased over the last 10-15 years. Some researchers associate the improvement of treatment outcomes with the development of combined and complex methods. The aim of the study is an improvement of the results of treatment of patients with soft tissue malignant histiocytoma on the basis of determination of factors, influencing local recurrence development. Materials and methods: The basis of our study was a comprehensive analysis of examination and treatment results of 130 patients with MFH of the soft tissue of limbs, of them in 84 patients (64.6%) the recurrences developed. The group included 45 (53.6%) males and 39 (46.4%) females. The major part of patients – 82.1% (60 patients) were older than 40 years. Results and conclusions: The number of recurrences after the treatment in general surgical facilities is 86.9%, whereas in the patients after the treatment in the specialized oncological facilities this figure is twice lower (40%). The characteristic of the medical facility where the patient receives his/her primary treatment largely affects the development of local recurrences, patients’ quality of life and overall survival rates. The surgical method remains the leading modality in the treatment of MFH of ST. Wide and radical excision of tumors in the specialized oncological facilities allows achieving better survival outcomes of the patients.

scholarly journals Limb Salvage Surgery without Radiation Therapy for Soft Tissue Sarcomas of the Foot

2021 ◽  
pp. 100096
Author(s):  
Keiko Hayakawa ◽  
Seiichi Matsumoto ◽  
Keisuke Ae ◽  
Taisuke Tanizawa ◽  
Yuki Funauchi ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Soft Tissue ◽  
Limb Salvage ◽  
Salvage Surgery ◽  
Soft Tissue Sarcomas ◽  
Limb Salvage Surgery

scholarly journals The Holevich modification of the first dorsal metacarpal artery flap in coverage of thumb skin losses

2019 ◽  
Vol 5 (6) ◽  
pp. 1144
Author(s):  
Prakash Panagatla ◽  
Sindhuri Kondapavuluri ◽  
Parvathi Ravula
Keyword(s):  
Soft Tissue ◽  
Range Of Motion ◽  
Soft Tissue Defects ◽  
Average Hospital ◽  
Sensory Recovery ◽  
Dorsal Metacarpal Artery ◽  
The Mean ◽  
And Function ◽  
Tissue Defects ◽  
First Dorsal Metacarpal Artery

<p class="abstract"><strong>Background:</strong> Reconstruction of complex soft tissue defects of the thumb is a challenging problem. It is very important to reconstruct these defects using sensate flaps as the thumb pulp needs to be sensate for implementing the various functions of the thumb. The aim of this study is to report our experience on the safety and functional outcome of the innervated first dorsal metacarpal artery flap (FDMA) for soft tissue defects of thumb.</p><p class="abstract"><strong>Methods:</strong> During 18 month period, nine patients with a mean age of 29 years, male:female ratio of 8:1 underwent coverage of soft tissue defects of the thumb, of various volar and dorsal defects, using an innervated first dorsal metacarpal artery flap. Indications were postburn deformities and acute trauma. None of the patients had any neurorraphy. Outcome of the Holevich modification of FDMA flap was assessed with regards to survival and function, reachability for different locations of the thumb, recovery of sensation in terms of two-point discrimination (2PD), donor morbidity with regards to deformity and range of motion were analysed.<strong></strong></p><p class="abstract"><strong>Results:</strong> The mean size of the defect was 6.7 cm<sup>2</sup>. Average hospital stay was 5 days. Average time of sensory recovery was 6 months. The mean 2PD was 4 mm (range 2-6 mm). All patients had a normal active range of motion in the donor finger. One of nine patients had distal flap marginal necrosis of 3-4 mm; it healed with debridement and regular dressings over 12 days.</p><p class="abstract"><strong>Conclusions:</strong> The Holevich modification ensures the safety of the innervated FDMA flap in thumb defect coverage with good recovery of sensation.</p>

scholarly journals The clinical outcomes of total femur prosthesis in patients with musculoskeletal tumors

SICOT-J ◽  
2019 ◽  
Vol 5 ◽  
pp. 23
Author(s):  
Takuya Kakimoto ◽  
Akihiko Matsumine ◽  
Kunihiro Asanuma ◽  
Takao Matsubara ◽  
Tomoki Nakamura ◽  
...  
Keyword(s):  
Overall Survival ◽  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Clinical Outcomes ◽  
Bone Tumor ◽  
Soft Tissue Sarcomas ◽  
Bone Sarcoma ◽  
Functional Score ◽  
Primary Bone ◽  
The Mean

Introduction: Reconstruction using a total femur prosthesis (TFP) remains a challenging procedure in musculoskeletal tumor surgery. The purpose of this study was to show the clinical outcomes of total femur replacement (TFR) in our institute. Methods: Nine patients underwent reconstruction with a TFP after the wide resection of malignant bone and soft-tissue tumors of the femur between January 2003 and April 2014. The mean age of the patients at the time of TFR was 47.5 years, and the mean follow-up period was 52.9 months. The histological diagnoses were as follows: bone sarcoma (n = 4), soft-tissue sarcoma invading the femoral bones (n = 4), and metastatic bone tumor (n = 1). Results: The oncological outcomes were as follows: three patients achieved continuous disease free, two patients were alive with disease, and four patients died from disease. The 3- and 5-year overall survival rates were 88.9% and 55.6%, respectively. The rate of the overall survival in patients with primary bone tumors (100% at 5 years) was significantly better than that in patients with primary soft tissue sarcomas (0% at 5 years) (p = 0.015). A deep infection occurred postoperatively in one patient, but the patient was successfully treated with surgical debridement and revision surgery. There were no patients who showed dislocation or aseptic loosening. The mean Musculo-Skeletal Tumor Society functional score was 58.5% (46.7–80.0), with scores of 65.5% in patients with a primary bone tumor and 50.8% in those with a primary soft-tissue sarcoma. Discussion: In the present study, the patients who underwent TFR due to bone invasion by soft tissue sarcoma had a worse prognosis than the bone sarcoma patients.

Impact of NICE guidelines on the survival of patients with soft-tissue sarcomas

2021 ◽  
Vol 103-B (3) ◽  
pp. 569-577
Author(s):  
Tomohiro Fujiwara ◽  
Robert J. Grimer ◽  
Scott Evans ◽  
Manuel Ricardo Medellin Rincon ◽  
Yusuke Tsuda ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Sarcomas ◽  
High Grade ◽  
Nice Guidelines ◽  
Number Of Patients ◽  
Mean Size ◽  
The Mean ◽  
The Uk ◽  
The Impact ◽  
Grade Tumour

Aims Urgent referral to a specialist centre for patients with a soft-tissue sarcoma (STS) has been recommended by the National Institute for Health and Care Excellence (NICE) in the UK since 2006. However, the impact of this recommendation on the prognosis for these patients remains unclear. We aimed to determine the impact of the NICE guidelines on the disease-specific survival (DSS) of patients with an STS. Methods A total of 2,427 patients with an STS referred to a supraregional centre in the ten-year periods before (n = 1,386) and after (n = 1,041) the issue of the NICE guidelines were evaluated. Results The mean size of the tumour was significantly smaller at the time of diagnosis (10.3 cm (SD 6.5) vs 9.1 cm (SD 6.2); p < 0.001) and the number of patients who had undergone an inadvertent excision significantly decreased (28% (n = 389) vs 20% (n = 204); p < 0.001) following the introduction of the NICE guidelines. The five-year DSS was 63% in the pre-NICE and 71% in post-NICE groups (p < 0.001). The improved survival was more significant for those with a high-grade tumour (pre-NICE, 48%; post-NICE, 68%; p < 0.001). In those with a high-grade tumour, the mean size of the tumour (11.6 cm (SD 6.2) vs 9.6 cm (SD 5.8); p < 0.001) and the number of patients with metastasis at the time of diagnosis (15% (n = 124 vs 10% (n = 80); p = 0.007) significantly decreased in the post-NICE group. Conclusion An improvement in survival was seen after the introduction of the NICE guidelines, especially in patients with a high-grade STS. More patients were referred at an earlier stage, indicating a clearer pathway after the issue of national policy for the management of STSs in the UK. Cite this article: Bone Joint J 2021;103-B(3):569–577.

Extremity Soft Tissue Sarcomas Treated with Limb Salvage Surgery and Amputation

1989 ◽  
pp. 127-130
Author(s):  
Örjan Berlin ◽  
Bertil Stener ◽  
Lennart Angervall ◽  
Lars-Gunnar Kindblom ◽  
Anders Odén ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Limb Salvage ◽  
Salvage Surgery ◽  
Soft Tissue Sarcomas ◽  
Limb Salvage Surgery

Usefulness of limb salvage surgery for bone and soft tissue sarcomas of the distal lower leg

2008 ◽  
Vol 134 (10) ◽  
pp. 1087-1095 ◽  
Author(s):  
Rui Niimi ◽  
Akihiko Matsumine ◽  
Katsuyuki Kusuzaki ◽  
Shigeyuki Kuratsu ◽  
Nobuhito Araki ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Limb Salvage ◽  
Salvage Surgery ◽  
Soft Tissue Sarcomas ◽  
Lower Leg ◽  
Limb Salvage Surgery ◽  
Distal Lower Leg

scholarly journals Intradialytic resistance training: an effective and easy-to-execute strategy

2019 ◽  
Vol 41 (2) ◽  
pp. 215-223
Author(s):  
Antônio Paulo André de Castro ◽  
Sergio Ribeiro Barbosa ◽  
Henrique Novais Mansur ◽  
Danielle Guedes Andrade Ezequiel ◽  
Mônica Barros Costa ◽  
...  
Keyword(s):  
Resistance Training ◽  
Adverse Events ◽  
Skeletal Muscles ◽  
Low Cost ◽  
Nephrology Care ◽  
The Mean ◽  
Muscle Groups ◽  
And Function

Abstract Chronic kidney disease (CKD) alters the morphology and function of skeletal muscles, thereby decreasing patient physical capacity (PC) and quality of life (QoL). Intradialytic resistance training (IRT) is a pragmatic tool used to attenuate these complications. However, IRT has not been strongly adopted in nephrology care centers. This study aimed to assess the efficacy and safety of a low-cost, easy-to-use IRT protocol. Methods: The study enrolled 43 patients (52.8 ± 13.85 years) on HD for five to 300 months followed from April 2014 to July 2017. The efficacy of IRT was assessed based on PC - derived from muscle strength (MS) and preferred walking speed (PWS) - and QoL. The occurrence of adverse events was used as a measure of safety. The IRT protocol consisted of exercises of moderate to high intensity for the main muscle groups performed three times a week. Results: The mean follow-up time was 9.3 ± 3.24 months, for a total of 4,374 sessions of IRT. Compliance to the protocol was 96.5 ± 2.90%, and patients presented significant improvements in MS (from 27.3 ± 11.58 Kgf to 34.8 ± 10.77 Kgf) and PWS (from 0.99 ± 0.29 m/s to 1.26 ± 0.22 m/s). Physical and emotional components of QoL also increased significantly. Conclusion: IRT led to significant increases in PC and higher scores in all domains of QoL. Important adverse events were not observed during intradialytic resistance training.

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