Operative Orthopadie und Traumatologie · 2025
[Resection of soft tissue sarcomas on the thigh].
Аннотация на английскомСтатьяОбзорНазвание и аннотация: Перевод в очереди
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Niethard Maya, Mahr Daniel, Geis Sebastian
Аннотация
OBJECTIVE: Complete tumor resection while maintaining oncologically required safety margins. The focus is on functional limb preservation, taking into account tumor spread in the individual compartments and the positional relationship to vascular and nerve courses.
INDICATIONS: Localized tumor disease and complete resection possible. No to acceptable postoperative functional restrictions. Palliative tumor resection in the case of imminent or existing exulceration, for pain reduction or in the case of solitary metastases.
CONTRAINDICATIONS: Tumors that are not surgically accessible. Advanced or progressive tumors with extensive metastases and short life expectancy. Complete postoperative loss of function of the extremity.
SURGICAL TECHNIQUE: Interdisciplinary planning in the tumor board. Access with consideration of the compartments, whereby the biopsy tract is resected. Dissection taking into account high quality (fascia/adventitia/perineurium/periosteum) and low quality (muscle/fat) resection margins. If necessary: muscular refixation, plastic reconstruction. Multilayer wound closure to reduce the dead space volume with drainage insertion.
POSTOPERATIVE MANAGEMENT: Compression therapy using thigh compression stockings or single-leg compression tights compression class 2 with pad. Lymphatic drainage. Physiotherapeutic mobilization taking functional restrictions into account. Oncological therapy/follow-up taking into account grading, resection margins and regression.
RESULTS: The outcomes of soft tissue sarcoma resection in the thigh are generally favorable, both oncologically and functionally. Early diagnosis and treatment in specialized centers can improve survival and reduce the amputation rate.
INDICATIONS: Localized tumor disease and complete resection possible. No to acceptable postoperative functional restrictions. Palliative tumor resection in the case of imminent or existing exulceration, for pain reduction or in the case of solitary metastases.
CONTRAINDICATIONS: Tumors that are not surgically accessible. Advanced or progressive tumors with extensive metastases and short life expectancy. Complete postoperative loss of function of the extremity.
SURGICAL TECHNIQUE: Interdisciplinary planning in the tumor board. Access with consideration of the compartments, whereby the biopsy tract is resected. Dissection taking into account high quality (fascia/adventitia/perineurium/periosteum) and low quality (muscle/fat) resection margins. If necessary: muscular refixation, plastic reconstruction. Multilayer wound closure to reduce the dead space volume with drainage insertion.
POSTOPERATIVE MANAGEMENT: Compression therapy using thigh compression stockings or single-leg compression tights compression class 2 with pad. Lymphatic drainage. Physiotherapeutic mobilization taking functional restrictions into account. Oncological therapy/follow-up taking into account grading, resection margins and regression.
RESULTS: The outcomes of soft tissue sarcoma resection in the thigh are generally favorable, both oncologically and functionally. Early diagnosis and treatment in specialized centers can improve survival and reduce the amputation rate.