21931 Excision, tumor, soft tissue of back or flank, subcutaneous; 3 cm or greater

Name of the Procedure:

Excision of a Tumor, Soft Tissue of Back or Flank, Subcutaneous; 3 cm or Greater

Summary

This procedure involves the surgical removal of a tumor located just beneath the skin in the back or flank area. It is typically performed when the tumor is 3 centimeters or larger.

Purpose

The procedure addresses the presence of a subcutaneous tumor in the back or flank, which could be benign or malignant. The goal is to remove the tumor to alleviate symptoms, prevent further growth, and allow for pathological examination to determine the nature of the tumor.

Indications

• Noticeable lump or mass in the back or flank area.
• Pain, discomfort, or functional impairment due to the tumor.
• Tumor size greater than 3 centimeters.
• Suspicion of malignancy based on imaging or other diagnostic tests.

Preparation

• Fasting may be required several hours before the procedure.
• Adjustment of certain medications, especially blood thinners, as advised by the healthcare provider.
• Pre-procedure imaging studies or biopsies to assess the tumor.
• Routine preoperative blood tests and physical examination.

Procedure Description

1. The patient is positioned appropriately on the surgical table.
2. Anesthesia is administered (local, regional, or general, depending on the case).
3. The surgical area is sterilized and draped.
4. An incision is made over the tumor.
5. The tumor and a margin of surrounding tissue are carefully excised.
6. The incision is closed with sutures or staples.
7. A dressing is applied to the surgical site.

Tools such as scalpels, forceps, and surgical scissors are used. Anesthesia type depends on the patient's condition and the surgeon's preference.

Duration

The procedure typically takes about 30 minutes to 1 hour, depending on the tumor's size and location.

Setting

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

Personnel

• Surgeon
• Surgical nurse
• Anesthesiologist (if general or regional anesthesia is used)
• Surgical technologist

Risks and Complications

Common risks include:

• Infection at the incision site
• Bleeding or hematoma
• Pain
• Scarring

Rare complications:

• Damage to nearby structures
• Anesthetic complications
• Tumor recurrence

Benefits

• Removal of the tumor.
• Relief from symptoms such as pain or discomfort.
• Pathological assessment to determine the nature of the tumor.
• Potential prevention of further complications if the tumor is malignant.

Recovery

• Post-procedure care includes keeping the incision site clean and dry.
• Pain management with prescribed medications.
• Some activity restrictions to allow for healing.
• Follow-up appointments to monitor recovery and discuss pathology results.

Recovery time ranges from a few days to a few weeks, depending on the individual patient's condition and the extent of the surgery.

Alternatives

• Observation and regular monitoring, especially if the tumor is asymptomatic and non-suspicious.
• Non-surgical treatments like injection therapy, though these are less common for subcutaneous tumors.
• Pros and cons: Surgery provides a definitive diagnosis and treatment, while observation avoids surgical risks but entails ongoing uncertainty.

Patient Experience

During the procedure, if local or regional anesthesia is used, the patient may feel pressure or tugging but should not feel pain. Post-procedure, the patient may experience some pain and discomfort at the incision site, which can be managed with pain medications. Swelling and bruising are also common but should subside within a few days to weeks.