Name of the Procedure:

Excision of Tumor, Soft Tissue of Shoulder Area, Subfascial (e.g., Intramuscular); 5 cm or Greater

Summary

This procedure involves surgically removing a tumor from the soft tissue beneath the fascia (a layer of connective tissue) in the shoulder area. The tumor size in this context is 5 centimeters or larger.

Purpose

Medical Condition: Tumor growth in the soft tissue of the shoulder, which could be benign or malignant. Goals: To remove the tumor to alleviate symptoms, prevent its growth or spread, and obtain tissue for further diagnostic evaluation.

Indications

Symptoms: Pain, swelling, or reduced mobility in the shoulder area. Conditions: Suspected or confirmed soft tissue tumors, both benign and malignant. Patient Criteria: Patients with a soft tissue mass of 5 cm or greater in the shoulder area, often confirmed via imaging studies.

Preparation

Pre-procedure Instructions:

• Fasting for 6-8 hours before the surgery.
• Adjusting medications as per the doctor's advice.
• Arranging for someone to drive the patient home post-procedure. Diagnostic Tests:
• MRI or CT scan of the shoulder to evaluate the tumor.
• Blood tests to check overall health and fitness for surgery.

Procedure Description

1. Anesthesia: General anesthesia is administered to put the patient to sleep.
2. Incision: A surgical incision is made over the tumor site.
3. Exposure: The fascia is opened to expose the tumor.
4. Excision: The tumor is carefully dissected and removed from the surrounding tissues.
5. Closure: The surgical site is closed with stitches or staples, and a dressing is applied. Tools/Equipment: Scalpel, forceps, retractors, electrocautery (to control bleeding), sutures.

Duration

Typically, 1 to 2 hours depending on the tumor's size and complexity.

Setting

Performed in a hospital or specialized surgical center.

Personnel

• Surgeon
• Surgical nurses
• Anesthesiologist
• Surgical technologist

Risks and Complications

Common Risks: Bleeding, infection, pain at the surgical site. Rare Risks: Nerve damage, incomplete removal of the tumor, recurrence of the tumor. Management: Postoperative antibiotics for infection, pain management strategies, careful surgical technique to minimize complications.

Benefits

Expected Benefits:

• Relief from pain and other symptoms caused by the tumor.
• Prevention of tumor growth or spread.
• Ability to perform a histopathological analysis of the tumor for accurate diagnosis. Timeline: Beneficial outcomes are generally noticed within weeks after surgery.

Recovery

Post-procedure Care:

• Pain management with prescribed medications.
• Keeping the surgical site clean and dry.
• Limited use of the shoulder initially.
• Physical therapy as recommended. Recovery Time: Full recovery may take several weeks to a few months, with follow-up appointments to monitor healing and ensure no recurrence.

Alternatives

Other Treatment Options:

• Observation (if the tumor is benign and not causing symptoms).
• Radiation or chemotherapy (especially if malignancy is suspected or confirmed). Pros and Cons:
• Observation avoids surgery but may allow the tumor to grow.
• Radiation or chemotherapy can be effective for malignant tumors but have their own side effects.

Patient Experience

During the Procedure: The patient will be under general anesthesia and will not feel or remember the procedure. After the Procedure: Expect some pain and discomfort at the surgical site, managed with medications. Gradual return of shoulder function through physical therapy. Pain Management: Postoperative pain relief generally involves oral painkillers and possibly local anesthesia around the surgical site.

By following these guidelines, patients and healthcare providers can ensure the optimal outcome and smooth recovery from the excision of a soft tissue tumor in the shoulder.