Abstract
This study reviewed our institution’s experience in collaborative surgery between vascular surgery and orthopedic surgery in the treatment of soft tissue sarcomas (STS). We reviewed our institution’s surgical experience with STS between July 1, 2012, and January 31, 2015, since the addition of a specialized cancer treatment center and a dedicated oncologic division of orthopedic surgery. Surgical cases performed in conjunction with both orthopedic and vascular surgery were reviewed. We identified 62 patients with a total of 65 surgical resections performed for STS in our study period. There were no perioperative deaths in the study period. Fifty-eight lower extremity resections (89.2%), four upper extremity resections (6.2%), and three pelvis resections (4.6%) were performed. Ten cases required a vascular intervention (15.4%). These interventions included bypass in two patients (20%), primary repair of a named vessel in four patients (40%), and ligation of a named vessel in two patients (20%). Tumor recurred in three patients (4.6%), requiring further resection. Seven patients required an amputation (11.9%). The average size of tumor removed was 1776 cm3 (range, 5-36,300 cm3). The quality of surgical resection is paramount in optimal treatment of STS; however, aggressive resection of STS can result in vascular complications and unacceptable functional outcomes. A multidisciplinary surgical team including orthopedic and vascular teams may improve treatment by optimizing complex resections that may require involved vascular control or reconstruction. We present the largest reported series of orthopedic oncologic resection performed in conjunction with a vascular surgeon.
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