The procedure performed to remove bone cancers and soft tissue in the limbs is called limb salvage surgery.
The procedure is also otherwise known as limb-sparing surgery.
Limb salvage surgery is done in order to avoid amputation.
Goals
Some of the primary goals of limb salvage surgery include:
- Avoiding amputation
- Removal of cancer
- Preservation of appearance
- Maintaining the greatest possible degree of function
While often carried out in tumors and bone sarcomas, limb salvage surgery is also an option in soft tissue sarcomas affecting the extremities.
Nowadays, the procedure has become the ideal alternative to amputation.
It has also become the recommended treatment option for cancers that spread slowly (from the limb to other body parts), or those cancers that have not spread to the soft tissues yet.
Years prior, the usual treatment route of those patients with cancer in the limbs is amputation of the extremity affected.
Fortunately, nowadays, patients no longer have to lose their limbs in order to treat the cancer.
This development can be credited to numerous factors—survival rate of patients treated using chemotherapy, advanced imaging methods (CT scans and MR), and remarkable improvements in surgical techniques both resection and reconstruction, to name a few.
In recent years, limb salvage surgery has also become one of the recommended option for patients with chronic bone and degenerative conditions like rheumatoid arthritis.
Likewise, it has also become one of the treatment options for those patients that are considered candidates for diabetic limb amputation and those with chronic and acute limb wounds.
Diagnosis
Before your doctor will decide if limb salvage surgery is apt, the following key factors are taken into consideration:
- Type of cancer
- Its size
- Its location
- The cancer’s progression
- Age of the patient
- Overall health of the patient
When recommended, doctors will make sure the patient understands the likely outcome of the surgery.
While proven effective, there is still that possibility that the implant will fail and additional surgery might be required.
In some cases, amputation might become an option.
Physical and occupation therapists can also help patients who are candidates for limb salvage surgery.
Preparation for the surgery may include introduction of exercises that can help strengthen the muscles and ambulation (walking).
ROM or range of motion exercises patients would need to do after the operation will also be taught.
Procedure
Limb-sparing surgery involves not just removing the cancer but also at least an inch of the healthy tissue surrounding it.
Chemotherapy, radiation, or in some cases, a combination of both might be recommended to shrink the tumor before the procedure is performed.
Limb salvage surgery has 3 stages:
- The cancer as well as a margin of healthy tissue is removed.
- Bone graft is performed or prosthesis is implanted when necessary.
- Wound is closed by transferring soft tissue or muscle from other parts of the body.
Surgical Techniques
Soft Tissue Sarcomas
Nowadays, a staggering 80 percent of cases of soft tissue sarcomas affecting the extremities are treated through limb salvage surgery.
The procedure entails removing the limb nodes, tumor, and the tissues where the cancer has spread.
An inch of the healthy tissue surrounding the tumor will also be removed.
For cases of soft tissue sarcomas that has spread to the lungs, the procedure will involve removing the original tumor, shrinking the lung tumor through chemotherapy or radiation, and surgically removing the lung tumor.
Bone Tumors
Treating low grade bone tumor and its components, doctors will remove the malignant lesion alongside a cuff of the healthy tissue.
Aftercare
Generally, patients will have to remain in the hospital for 5 to 10 days after the procedure.
Sensation and blood flow of the extremity affected will be monitored.
The hospital stay is also required to help ensure the patient does not develop any life-threatening complications like pneumonia, deep-vein thrombosis, and pulmonary embolism.
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