Limb salvage in lower-extremity sarcomas and technical details about vascular reconstruction

Revascularization after segmental resection of lower extremity soft tissue sarcomas

“…Soft-tissue sarcomas of the extremity involving major vascular structures were historically managed with amputation [1][2][3]. More recently, patients with soft tissue sarcomas involving vessels have been successfully managed by limb salvage surgery consisting of wide en bloc resection of the tumor along with the vessels and reconstruction of the segmental vascular defect with synthetic or autogenous saphenous vein grafts [1][2][3][4].…”

“…More recently, patients with soft tissue sarcomas involving vessels have been successfully managed by limb salvage surgery consisting of wide en bloc resection of the tumor along with the vessels and reconstruction of the segmental vascular defect with synthetic or autogenous saphenous vein grafts [1][2][3][4]. Resected arteries are always reconstructed in order to preserve viability of the limb, but venous reconstruction is not considered to be essential for limb salvage [5,6].…”

Treatment of patients with "high grade" extremity localized chondrosarcoma. Preliminary results

“…Similar or better results are reported in many studies. 9,10,[13][14][15] Eight of 18 patients (44%) in our study had a high-grade chondrosarcoma and…”

“…10,11 Several options for limb-sparing procedures were available: 12 -resection arthrodesis and other special indication techniques (Figures 3a-c), 3,11 -modular or special expanding endoprosthesis (Figures 3d, 3f), 13,14 -cortico-spongious or bulk allograft (Figure 3e). 13 with criteria for limb-salvage. After the hystopathological assessment of a resected high-grade chondrosarcoma, 6/8 patients (75%) had a bad response to neoadjuvant chemotherapy.…”

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

“…There is not universal agreement on this point, and other reports suggest that there is no superior advantage to autologous graft over synthetic graft in terms of patency in the longer term [2,23,31] . Against these observations, it has been argued that saphenous graft may be of inadequate length for reconstructive purposes, and harvest carries additional site to the tumour [5, [14][15][16] . The layer is opened like a book, allowing the vessel to be mobilized and released.…”