Surgery is one of the most common treatment options for soft- tissue sarcomas. The surgery for sarcoma aims to remove the entire tumor along with some of the healthy tissues surrounding the tumor. In some cases, limb amputation surgery is required.
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Isolated Limb Perfusion: It is the technique used to manage locally advanced sarcomas. It is a highly effective strategy for limb preservation. It involves the perfusion of chemotherapeutic drugs for 60 minutes under mild hyperthermia. The procedure is done under general anesthesia. The surgeon makes an incision on the leg or arm to detect the main vessels. A large tube is placed in the vein and the artery, along with a tourniquet on the limb. It ensures that there is no blood supply to the legs so that the chemotherapeutic drugs are not leaked into the systemic circulation. The oxygen and chemotherapy drugs are added to the patient's blood and infused into the limb.
Isolated Hepatic Perfusion: It is a procedure for delivering high-dose chemotherapeutic drugs while lowering extra-hepatic toxicity. The procedure is used in patients with tumors that cannot be resected with surgery. The vascular exclusion of the liver is done through clamping and portal and arterial inflow control. Isolated hepatic perfusion aims to achieve the maximum anti-cancer effect of the drugs while reducing systemic toxicity.
Laparoscopic Surgeries for Metastatic Disease: Laparoscopic surgeries are minimally invasive surgeries used for several conditions involving sarcoma metastasis. The surgery uses a laparoscope to visualize the abnormal cells, following which the instruments are inserted for tumor resection.
Amputation and Limb Sparing Surgery: Several surgical techniques are available that remove the tumor without limb amputations. These surgeries are known as limb-sparing surgeries. However, certain situations require limb amputation surgery. The surgeon may also remove muscles, important nerves, blood vessels, and bones in patients with sarcoma.
Limb and Pelvic Reconstruction: Limb reconstruction surgery is performed on patients after sarcoma treatment. Limb reconstructive surgery aims to provide functional and durable limbs to patients who have undergone limb amputation. Pelvic reconstruction after sarcoma treatment involves pelvis reconstruction, especially in patients with acetabular resection.
