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Minimally Invasive Isolated Limb Perfusion (MI-ILP) for Locally Advanced Melanomas and Sarcomas of the Extremity
Published on: January 31, 2025
Limb conservation in extremity soft tissue sarcomas with vascular involvement
Rajaraman Ramamurthy1, Jagadish Chandra Bose Soundrarajan, Viswanathan Mettupalayam
1Department of Surgical Oncology, Govt Royapettah Hospital, Chennai, India.
Indian Journal of Orthopaedics
|October 20, 2009
Summary
Limb salvage surgery is feasible for lower extremity sarcomas involving major vessels, offering good long-term outcomes despite increased wound complications. This approach avoids amputation in complex sarcoma cases.
Area of Science:
- Orthopedic Oncology
- Vascular Surgery
- Surgical Oncology
Background:
- Major neurovascular involvement and large tumors often necessitate amputation for extremity sarcomas.
- This study investigates limb salvage surgery feasibility in cases with major vessel involvement.
Purpose of the Study:
- To explore the feasibility of limb salvage surgery in extremity sarcoma with major vessel involvement.
- To compare oncological outcomes and surgery-related morbidities with existing literature.
Main Methods:
- Retrospective review of limb salvage surgeries (2005-2008) for lower extremity sarcomas involving femoral vessels.
- Analysis of four cases and comparison with a literature review.
Main Results:
- Wide monobloc excision with vascular resection and reconstruction using reversed saphenous vein grafts was performed.
- Tumor-free margins were achieved in all patients.
- Outcomes included local recurrence (1), distant metastasis (1), and good functional limb in survivors; one patient required amputation due to arterial blowout.
Conclusions:
- Major neurovascular involvement is not an absolute contraindication for limb salvage in extremity sarcomas.
- While wound complications may increase, good long-term functional outcomes and local control are achievable.
- Literature supports the efficacy of vascular resection and reconstruction for limb salvage in these complex cases.
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