Resection and reconstruction of pelvic and extremity soft tissue sarcomas with major vascular involvement: Current concepts  

作　　者：Niall P Mc Goldrick Joseph S Butler Maire Lavelle Stephen Sheehan Sean Dudeney Gary C O'Toole 

机构地区：[1]National Sarcoma Service, Department of Trauma and Orthopaedic Surgery, St Vincent’s University Hospital [2]Department of Histopathology, St Vincent’s University Hospital [3]Department of Vascular Surgery, St Vincent’s University Hospital

出　　处：《World Journal of Orthopedics》2016年第5期293-300,共8页世界骨科杂志（英文版）

摘　　要：Soft tissue sarcoma accounts for approximately 1% of all cancers diagnosed annually in the United States. When these rare malignant mesodermal tumours arise in the pelvis and extremities, they may potentially encase or invade large calibre vascular structures. This presents a major challenge in terms of safe excision while also leaving acceptable surgical margins. In recent times, the trend has been towards limb salvage with vascular reconstruction in preference to amputation. Newer orthopaedic and vascular reconstructive techniques including both synthetic and autogenous graft reconstruction have made complex limb-salvage surgery feasible. Despite this, limb-salvage surgery with concomitant vascular reconstruction remains associated with higher rates of post-operative complications including infection and amputation. In this review we describe the initial presentation and investigation of patients presenting with soft tissue sarcomas in the pelvis and extremities, which involve vascular structures. We further discuss the key surgical reconstructive principles and techniques available for the management of these complex tumours, drawn from our institution's experience as a national tertiary referral sarcoma service.Soft tissue sarcoma accounts for approximately 1% of all cancers diagnosed annually in the United States. When these rare malignant mesodermal tumours arise in the pelvis and extremities, they may potentially encase or invade large calibre vascular structures. This presents a major challenge in terms of safe excision while also leaving acceptable surgical margins. In recent times, the trend has been towards limb salvage with vascular reconstruction in preference to amputation. Newer orthopaedic and vascular reconstructive techniques including both synthetic and autogenous graft reconstruction have made complex limb-salvage surgery feasible. Despite this, limb-salvage surgery with concomitant vascular reconstruction remains associated with higher rates of post-operative complications including infection and amputation. In this review we describe the initial presentation and investigation of patients presenting with soft tissue sarcomas in the pelvis and extremities, which involve vascular structures. We further discuss the key surgical reconstructive principles and techniques available for the management of these complex tumours, drawn from our institution's experience as a national tertiary referral sarcoma service.

关 键 词：SARCOMA EXTREMITIES Vascular surgical procedures Limb SALVAGE RECONSTRUCTION 

分 类 号：R738.6[医药卫生—肿瘤]