21558 Radical resection of tumor (eg, sarcoma), soft tissue of neck or anterior thorax; 5 cm or greater

Name of the Procedure:

Radical resection of tumor (eg, sarcoma), soft tissue of neck or anterior thorax; 5 cm or greater

Summary

This surgical procedure involves the complete removal of a tumor that is 5 cm or larger, located in the soft tissue of the neck or the front part of the chest. The goal is to eliminate the tumor along with any surrounding tissue that may be affected, to reduce the risk of the cancer spreading or recurring.

Purpose

The procedure addresses the removal of malignant tumors, such as sarcomas, in the neck or anterior thorax. The main goal is to achieve a cancer-free margin around the tumor, minimizing the chances of recurrence and improving long-term survival rates.

Indications

• Presence of a large (5 cm or greater) soft tissue tumor in the neck or anterior thorax
• Tumor diagnosed as malignant, such as sarcoma
• Tumor causing symptoms like pain, difficulty swallowing, or breathing issues
• Previous tests indicating the tumor’s aggressive nature or potential to spread

Preparation

• Patients are usually instructed to fast for 8-12 hours before surgery.
• Adjustments might be made to current medications; blood thinners typically need to be stopped.
• Diagnostic imaging like MRI or CT scans may be conducted to better visualize the tumor.

Procedure Description

1. The patient is placed under general anesthesia.
2. An incision is made over the tumor site.
3. The surgeon carefully removes the tumor along with a margin of surrounding healthy tissue.
4. In some cases, additional structures (e.g., part of a muscle or a nearby lymph node) may also need to be removed.
5. The surgical area is closed with sutures or staples.
6. Drains might be placed to prevent fluid accumulation.
7. The removed tissue is sent for pathological examination.

Duration

The procedure typically takes between 2 to 4 hours, depending on the tumor size and complexity of the case.

Setting

This procedure is conducted in a hospital operating room, often requiring a short to extended hospital stay for recovery.

Personnel

• Lead surgeon (specialized in oncologic surgery)
• Surgical assistants
• Anesthesiologist
• Nursing staff and surgical technologists

Risks and Complications

• Infection at the surgical site
• Bleeding or hematoma formation
• Nerve damage leading to weakness or loss of function in nearby muscles
• Blood clots
• Adverse reactions to anesthesia

Benefits

• Complete removal of the tumor with a good margin to decrease the chance of recurrence.
• Potentially increased survival rate and reduced likelihood of metastasis.
• Symptom relief, such as reduced pain or improved function of the affected area.

Recovery

• Hospital stay of a few days for monitoring and initial recovery.
• Pain management typically includes medications.
• Instructions to avoid strenuous activities for 4-6 weeks.
• Follow-up appointments for wound care, removing stitches or staples, and ongoing monitoring through imaging.

Alternatives

• Radiation therapy or chemotherapy, either as an adjunct or standalone treatment.
• Less invasive surgery, if the tumor is small or less aggressive.
• Monitoring and watchful waiting in certain low-risk cases.

Patient Experience

During the procedure, patients are under general anesthesia and will not feel pain. Post-surgery, there might be discomfort, pain, and limited movement in the treated area. Pain management strategies and supportive care are provided to ensure a relatively comfortable recovery.