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Excision, tumor, soft tissue of foot or toe, subfascial (eg, intramuscular); 1.5 cm or greater

CPT4 code

Name of the Procedure:

Excision of Tumor, Soft Tissue of Foot or Toe, Subfascial (e.g., Intramuscular); 1.5 cm or Greater

Summary

This surgical procedure involves the removal of a tumor located within the soft tissues under the fascia (connective tissue) of the foot or toe. The tumor must be at least 1.5 centimeters in size. The aim is to excise the tumor while preserving as much of the surrounding, healthy tissue as possible.

Purpose

The procedure addresses the presence of a soft tissue tumor, which may be benign or malignant. The goal is to remove the tumor to prevent its spread, alleviate symptoms, and potentially improve foot function.

Indications

  • Presence of a palpable or visible soft tissue mass in the foot or toe.
  • Pain, discomfort, or functional impairment caused by the tumor.
  • Diagnostic imaging that suggests the tumor is of a significant size (1.5 cm or greater).
  • Doctor's recommendation based on the potential for malignancy or growth.

Preparation

  • Fasting for at least 6-8 hours prior to the procedure if general anesthesia is to be used.
  • Blood tests and imaging studies (e.g., MRI or CT scans) to assess the tumor size and location.
  • Review of medical history and medication adjustments, especially blood thinners.

Procedure Description

  1. Patient is positioned and administered anesthesia—local, regional, or general depending on the extent of the surgery.
  2. Surgeons clean and sterilize the foot or toe area.
  3. An incision is made over the tumor's location.
  4. The tumor is carefully dissected and removed along with a margin of healthy tissue to ensure complete excision.
  5. The incision site is closed with sutures or staples.
  6. A sterile dressing is applied.

Duration

The procedure typically takes 1 to 2 hours, depending on the complexity and size of the tumor.

Setting

The surgery is usually performed in a hospital operating room or an outpatient surgical center.

Personnel

  • Surgeon: Performs the excision.
  • Anesthesiologist: Administers and monitors anesthesia.
  • Surgical nurse: Assists during the procedure.
  • Surgical technician: Prepares and hands instruments to the surgeon.

Risks and Complications

  • Infection at the incision site.
  • Bleeding or hematoma formation.
  • Damage to surrounding nerves, vessels, or tissues.
  • Recurrence of the tumor.
  • Adverse reactions to anesthesia.

Benefits

  • Removal of a potentially harmful tumor.
  • Relief from symptoms such as pain or discomfort.
  • Improved foot function and mobility.
  • Reduced risk of tumor progression or metastasis.

Recovery

  • Keep the surgical site clean and dry.
  • Follow pain management guidelines, which may include prescribed pain medication.
  • Limit weight-bearing activities as directed by your doctor.
  • Attend follow-up appointments for wound checks and suture removal.
  • Full recovery typically takes several weeks, with a gradual return to regular activities.

Alternatives

  • Observation: In cases where the tumor is small and asymptomatic.
  • Radiation therapy or chemotherapy: If the tumor is malignant and not completely resectable.
  • Non-surgical methods: Such as steroid injections for benign, non-painful lesions.

Patient Experience

Patients can expect some discomfort and swelling post-surgery, which can be managed with pain relief medications. Following the doctor's care instructions will aid in a quicker recovery. Proper wound care is crucial to prevent infection and ensure healing.

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