The surgery done to remove cancers and soft tissue in the limbs is known as limb salvage surgery.
Limb salvage surgery is also often carried out to avoid amputation.
What are the primary aims of the procedure?
The following are some of the key goals of limb salvage surgery:
- Prevent amputation
- Cancer removal
- Preserving the patient’s appearance
- Ensuring the highest possible degree of function in the affected limb is preserved
Otherwise known as limb-sparing surgery, limb salvage surgery entails removal of the cancer and at the very least an inch of the surrounding healthy tissues.
Limb salvage surgery has three stages:
- Cancer removal and a margin of the surrounding healthy tissue.
- Bone graft or prosthesis implant when necessary.
- Closing of the wound by transferring soft tissue or muscle from other body parts to the surgical site.
Many years prior, the standard treatment approach of patients with cancer in the limb often includes amputation of the extremity affected.
Thankfully, today, amputation does not have to be the only option.
With significant improvements in surgical techniques, chemotherapy, and imaging methods, amputation is no longer the only alternative.
In recent years, limb-sparing surgery has also become the treatment route for those patients with bone diseases, chronic degenerative joint diseases, acute or chronic limb wounds, and those patients who are considered candidates for diabetic limb amputation.
What are the preparations before the procedure?
Before doctors will decide if limb salvage surgery is indeed the best option, key factors are taken into consideration.
Some of the primary factors include:
- Size of the tumor
- Location of the tumor
- The type of cancer
- The age of the patient
- The condition’s progression
- The overall health of the patient
Once the doctors decide that limb salvage surgery is the best option, patient will be given information and insight as to the likely outcome.
Patients will also be advised that in the event of any implant failure, additional surgery might be required and even amputation might become an option.
Physical and occupational therapists will prepare the patient for surgery by introducing range of motion, muscle-strengthening, and ambulation exercises they need to perform after the surgery.
What are some of the surgical techniques employed?
The lesion that is malignant and at least a cuff of healthy tissue is removed when treating low-grade bone tumors and some of its components.
However, when treating high-grade tumors, muscles, bones, and other tissues affected are removed.
Soft Tissue Sarcomas
A staggering 80 percent of soft tissue sarcomas affecting the extremities are treated with limb-sparing surgery.
During the procedure, the tumor, lymph nodes, as well as the cancerous tissues are removed.
At least 2.54 cm of the surrounding healthy tissues are also removed.
Radiation and chemotherapy may be administered before or after the procedure.
Radiation may also be administered during the procedure itself.
It is carried out by utilizing a special application that will be placed against the surface where the tumor is removed.
Tubes containing radioactive pellets will then be inserted.
The tubes will have to stay in place during the procedure and will only be removed after a few days.
What are the recommended aftercare regimen after the surgery?
Patients will often remain in the hospital for at least 5 to 10 days after the surgery.
Sensation and blood flow in the affected extremity will be monitored closely.
Nurses will also check for signs of deep-vein thrombosis, pneumonia, and pulmonary embolism.
Broad-spectrum antibiotics will also be prescribed the first 48 hours after the surgery.
To prevent blood clots from forming, antiembolism stockings and medications (prophylactic anticoagulants) will be provided.