21556 Excision, tumor, soft tissue of neck or anterior thorax, subfascial (eg, intramuscular); less than 5 cm

Name of the Procedure:

Excision, Tumor, Soft Tissue of Neck or Anterior Thorax, Subfascial (e.g., Intramuscular); Less Than 5 cm

Summary

This procedure involves the surgical removal of a tumor located in the soft tissues of the neck or the front part of the chest, beneath the fascia (a layer of connective tissue), and penetrating into the muscle. The tumor being removed is less than 5 centimeters in size.

Purpose

The primary purpose of this procedure is to remove a benign or malignant tumor that could potentially cause pain, discomfort, or other medical complications if left untreated. The goal is to improve the patient's health and prevent the tumor from growing or spreading.

Indications

• A detectable lump or mass in the neck or anterior thorax.
• Pain or discomfort in the affected area.
• Diagnostic imaging (e.g., MRI, CT scan) indicating a subfascial tumor.
• Biopsy results suggesting the need for surgical removal.

Preparation

• Patients may be instructed to fast for 8-12 hours before the procedure.
• Certain medications may need to be adjusted or paused, under medical advice.
• Preoperative assessments, such as blood tests and imaging studies, may be necessary.
• Consent and preoperative briefing regarding the procedure and anesthesia will be conducted.

Procedure Description

1. Anesthesia: The patient will receive general anesthesia to ensure they are asleep and pain-free during the procedure.
2. Incision: A surgical incision is made over the location of the tumor.
3. Accessing the Tumor: The surgeon carefully dissects through the skin, subcutaneous tissue, and fascia to reach the tumor.
4. Tumor Removal: The tumor is excised along with some surrounding healthy tissue to ensure complete removal.
5. Closure: The incision is closed with sutures or staples, and a sterile dressing is applied.

• Tools: Scalpel, forceps, retractors, surgical scissors, sutures/staples.
• Technology: Imaging guidance if needed.

Duration

The procedure typically takes 1-2 hours, depending on the complexity and exact location of the tumor.

Setting

This procedure is usually performed in a hospital operating room or a specialized surgical center.

Personnel

• Surgeon
• Anesthesiologist
• Surgical Nurses
• Possibly a surgical technician and additional support staff

Risks and Complications

• Common risks: Infection, bleeding, and reactions to anesthesia.
• Rare risks: Damage to nearby structures (e.g., nerves, blood vessels), incomplete tumor removal, and scarring.
• Management of complications may involve additional medications, surgery, or prolonged hospital stay.

Benefits

• Relief from symptoms caused by the tumor.
• Preventing further growth or spread of the tumor.
• Improved quality of life and reduced risk of complications associated with the tumor.

Recovery

• Patients may need to stay in the hospital for a day or two, depending on their recovery.
• Pain management typically involves prescribed pain relief medications.
• Follow-up appointments to monitor healing and remove sutures.
• Patients should avoid strenuous activities for several weeks and follow specific care instructions for the incision site.

Alternatives

• Observation: For non-symptomatic tumors.
• Radiation Therapy or Chemotherapy: For certain types of tumors.
• Minimally Invasive Procedures: Such as needle biopsy or targeted ablation.
• Each alternative has its own risks and benefits, which should be discussed with a healthcare provider.

Patient Experience

During the procedure, the patient will be under general anesthesia and will not feel any pain. Post-procedure, the patient may experience discomfort at the incision site, managed by pain medications. Proper wound care and activity restrictions are vital for recovery. Most patients are able to resume normal activities within a few weeks, depending on their overall health and the complexity of the surgery.