Name of the Procedure:

Radical Resection of Tumor; Scapula

Summary

In layman's terms, a radical resection of a tumor in the scapula involves surgically removing the tumor along with some surrounding tissue from the shoulder blade to ensure no cancerous cells are left behind.

Purpose

This procedure addresses malignant or aggressive benign tumors located in the scapula. The goal is to remove the tumor entirely to prevent its spread and to improve the patient’s quality of life.

Indications

• Presence of a malignant tumor in the scapula.
• Aggressive benign tumors causing symptoms or structural damage.
• Patient's overall health allows for surgery.
• Imaging and biopsy results confirming the tumor's nature and location.

Preparation

• Fasting for at least 8 hours before the procedure.
• Adjusting or pausing certain medications as advised by the doctor (e.g., blood thinners).
• Pre-operative imaging studies like CT scans or MRIs.
• Blood tests and overall health assessment to ensure fitness for surgery.

Procedure Description

1. The patient is placed under general anesthesia.
2. An incision is made over the scapula area to access the tumor.
3. The tumor and a margin of surrounding healthy tissue are carefully removed.
4. The surgical area is inspected to ensure complete tumor removal.
5. The incision is closed with sutures or staples, and a drainage tube may be placed.
6. A dressing is applied to the surgical site.

Tools and equipment include scalpels, surgical retractors, electrocautery devices, and possibly specialized instruments for bone cutting.

Duration

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

Setting

This procedure is performed in a hospital surgical suite.

Personnel

• Orthopedic surgeon or surgical oncologist.
• Anesthesiologist.
• Surgical nurses and technicians.
• Radiologist (for pre-operative and intra-operative imaging as needed).

Risks and Complications

• Common risks: infection, bleeding, blood clots, and adverse reactions to anesthesia.
• Rare risks: damage to nearby structures (nerves, blood vessels), incomplete removal of the tumor, recurrence of the tumor.
• Management includes antibiotics for infection, surgical intervention for significant bleeding, and close post-operative monitoring.

Benefits

• Complete removal of the malignant or aggressive tumor.
• Reduced risk of cancer spread or recurrence.
• Alleviation of symptoms caused by the tumor, such as pain or structural issues.

Benefits are typically realized within a few weeks post-surgery as the patient recovers.

Recovery

• Hospital stay for a few days post-surgery.
• Pain management with prescribed medication.
• Instructions for wound care and signs of infection to watch for.
• Physical therapy may be needed to restore shoulder function.
• Follow-up appointments to monitor recovery and ensure no recurrence.

Recovery time varies but can range from several weeks to a few months.

Alternatives

• Radiation therapy: less invasive but may not be as effective in completely removing the tumor.
• Chemotherapy: used for reducing tumor size or in conjunction with surgery.
• Conservative management: monitoring the tumor for changes if it's slow-growing or non-resectable.

Each alternative has its pros and cons, often balanced between effectiveness, invasiveness, and side effects.

Patient Experience

During the procedure, the patient will be under general anesthesia and won’t feel anything. After the procedure, they may experience pain, discomfort, and restricted movement in the shoulder, managed with pain medications and eventually physical therapy.

Comfort measures include pain management strategies, supportive care from nurses, and gradual reintroduction to physical activities based on recovery progress.