Adjuvant therapy: the effects on microvascular lower extremity reconstruction

Area of Science:

• Oncology
• Microsurgery
• Reconstructive Surgery

Background:

• Adjuvant therapy (chemotherapy, radiotherapy) is crucial for managing lower extremity neoplasms.
• Microsurgical free tissue transfer offers advanced reconstruction options for complex surgical defects.
• The impact of adjuvant therapy on free tissue transfer outcomes in lower extremity reconstruction requires evaluation.

Purpose of the Study:

• To evaluate the safety and efficacy of microvascular free tissue transfer for lower extremity reconstruction in patients receiving adjuvant therapy.
• To assess complication rates and functional outcomes in patients undergoing free tissue transfer with pre- or post-operative irradiation and/or chemotherapy.

Main Methods:

• Retrospective study of 22 patients (24 free tissue transfers) over a 5-year period.
• Patients received surgical resection for lower extremity neoplasms followed by adjuvant therapy (chemotherapy, radiotherapy, or both).
• The latissimus dorsi muscle was the most frequently transferred flap (N=15).

Main Results:

• A total of six complications occurred among 24 free tissue transfers, with no flap loss.
• Complication rates were similar across different adjuvant therapy regimens.
• All patients attempting limb salvage could ambulate postoperatively, except for one with local recurrence.

Conclusions:

• Adjuvant therapy does not increase the complication rate for free tissue transfer in the lower extremity.
• Free tissue transfer is a viable option for lower extremity reconstruction in patients undergoing adjuvant therapy, promoting better wound healing.
• Microsurgical reconstruction can be performed concurrently with adjuvant therapy without necessitating modifications to either treatment.