J Korean Med Sci.  2018 Oct;33(40):e265. 10.3346/jkms.2018.33.e265.

Outcomes after Arterial or Venous Reconstructions in Limb Salvage Surgery for Extremity Soft Tissue Sarcoma

Affiliations
  • 1Division of Vascular Surgery, Department of Surgery, Seoul National University College of Medicine, Seoul, Korea. skminmd@snuh.org

Abstract

BACKGROUND
Limb salvage surgery with vascular reconstruction is currently considered as the standard treatment for extremity soft tissue sarcoma (STS), showing equivalent oncologic outcome compared with amputation. In this retrospective study, the surgical and functional outcomes after arterial or venous reconstruction in limb salvage surgery for STS were analyzed.
METHODS
Consecutive patients who underwent vascular resection and reconstruction as part of limb salvage surgery for extremity STS from July 2009 to June 2015 were included in this study. Incidence of surgical complication, graft patency, and patients' functional outcome were reviewed.
RESULTS
During the study period, 14 arteries and 13 veins were reconstructed in 17 patients (artery only in 4, vein only in 3, artery and vein in 10). Autologous great saphenous vein (GSV) was the most commonly used vascular conduit in both arterial and venous reconstruction (78.6% and 77.0%). The patency of synthetic graft was significantly lower than that of the autologous vein conduit (log rank test, P = 0.001). Among 15 patients with tumors in lower extremity, 13 were ambulatory after limb salvage surgery. During median follow up of 23.3 months (interquartile range 39.9 months), 2 patients (11.7%) needed amputation of the initially salvaged limb due to local recurrence.
CONCLUSION
Limb salvage surgery of soft tissue tumor combined with vascular reconstruction showed favorable functional outcome with good local control. Autologous vein conduit is preferred over synthetic graft both in arterial and venous reconstruction.

Keyword

Blood Vessels; Limb Salvage; Extremities; Sarcoma

MeSH Terms

Amputation
Arteries
Blood Vessels
Extremities*
Follow-Up Studies
Humans
Incidence
Limb Salvage*
Lower Extremity
Recurrence
Retrospective Studies
Saphenous Vein
Sarcoma*
Transplants
Veins
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