Primary flap reconstruction of tissue defects after sarcoma surgery enables curative treatment with acceptable functional results: a 7-year review

BMC Surgery

Hannu Kuokkanen²  Minna Laitinen¹  Toni-Karri Pakarinen¹  Minna Tellervo Kääriäinen²  Ilkka Santeri Kaartinen²  Kristiina Elisa Hietanen²  Jenny Fabiola López² 

[1] Department of Orthopedics and Trauma, Unit of Musculoskeletal Diseases, Tampere University Hospital, Tampere, Finland;Department of Plastic Surgery, Unit of Musculoskeletal Diseases, Tampere University Hospital, Pirkanmaa Hospital District, Teiskontie 35, Tampere 33521, Finland

关键词: Survival;    Flap reconstruction;    Defect size;    Characteristics;    Sarcoma;   

Others  :  1215952
DOI  :  10.1186/s12893-015-0060-y

 received in 2014-06-04, accepted in 2015-05-29,  发布年份 2015

【 摘 要 】

Background

Sarcomas, a heterogeneous group of tumors, are challenging to treat and require multidisciplinary cooperation and planning. We analyzed the efficacy of flap reconstruction in patients with bone and soft tissue sarcoma.

Methods

Patient charts and operative records were retrospectively reviewed from January 2006 through October 2013 to identify sarcoma patient characteristics, postoperative complications, revisions, recurrences, and survival. Pedicled and/or free flap reconstruction was performed in 109 patients. Flap selection was based on defect size, and exposure of anatomically critical structures or major orthopedic implants.

Results

Of 109 patients, 71 (65.1 %) were men, and mean age was 56.4 years. Tumors most frequently located in a lower extremity (38.7 %). Primary sarcomas comprised 79.2 % and recurrences occurred in 18.9 %. Wide resection was performed for 65.7 %, and there were 10 planned amputations combined with flap reconstruction. A total of 111 tumors received 128 flaps: 76 pedicled flaps, 42 free flaps, and 5 combined (10 total) pedicled + free-flaps. The success rate was 94 % for the pedicled flap group, 97 % for the free-flap group, and 100 % for the pedicle + free-flap group. Of 35 patients, 5 developed deep prosthetic infections. Only one amputation due to disease progression was performed. Satisfactory functional outcome was achieved in 69 %. Survival rate during a mean (standard deviation) 3(2) year follow-up was 83.5 %.

Conclusions

Primary flap reconstruction after sarcoma surgery satisfies oncologic goals. Large tumors in difficult areas can be removed and complete tumor resection achieved. Our findings indicate a high survival rate after sarcoma surgery utilizing flap reconstruction and a low recurrence rate.

【 授权许可】

   
2015 López et al.

【 图 表 】

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