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Radical resection of tumor (eg, sarcoma), soft tissue of upper arm or elbow area; 5 cm or greater

CPT4 code

Name of the Procedure:

Radical Resection of Tumor (e.g., Sarcoma), Soft Tissue of Upper Arm or Elbow Area; 5 cm or Greater

Summary

Radical resection of a tumor involves the surgical removal of a large mass of abnormal tissue (5 cm or greater) from the soft tissues of the upper arm or elbow area. This procedure aims to thoroughly excise the tumor while preserving as much normal tissue as possible.

Purpose

The primary purpose of this procedure is to treat soft tissue sarcomas, which are malignant tumors that arise from connective tissues. The goal is to remove all tumor cells, reduce the risk of recurrence, and, if possible, maintain the function of the upper arm or elbow.

Indications

  • Presence of a diagnosed soft tissue sarcoma in the upper arm or elbow area.
  • Tumor size of 5 cm or greater.
  • Symptoms such as pain, swelling, or restricted movement.
  • Lack of response to other treatments such as radiation or chemotherapy.
  • Patient's overall health and ability to tolerate surgery.

Preparation

  • Fasting may be required before surgery.
  • Patients may need to stop certain medications as advised by their healthcare provider.
  • Pre-surgical imaging studies like MRI or CT scans to determine the tumor's size and exact location.
  • Blood tests and physical examination to assess fitness for surgery.

Procedure Description

  1. Anesthesia: General anesthesia is administered to ensure the patient is unconscious and pain-free.
  2. Incision: A surgical incision is made over the tumor site.
  3. Tumor Excision: The tumor and a margin of surrounding normal tissue are carefully removed to ensure no cancer cells are left behind.
  4. Reconstruction: If necessary, reconstructive techniques are employed to repair the area and preserve functionality.
  5. Closure: The incision is closed with sutures or staples, and a sterile dressing is applied.

Duration

The procedure typically lasts between 2 to 4 hours, depending on the tumor's size and complexity.

Setting

The surgery is performed in a hospital operating room or a specialized surgical center.

Personnel

  • Lead Surgeon (specialized in orthopedic or oncology surgery)
  • Surgical Assistant
  • Anesthesiologist or Nurse Anesthetist
  • Operating Room Nurses
  • Possibly a reconstructive/plastic surgeon if reconstruction is necessary

Risks and Complications

  • Infection
  • Bleeding or hematoma formation
  • Nerve or muscle damage
  • Recurrence of the tumor
  • Adverse reactions to anesthesia
  • Prolonged healing or wound complications

Benefits

  • Complete removal of the tumor and reduction of cancer recurrence risk.
  • Alleviation of symptoms caused by the tumor, such as pain and swelling.
  • Potential for improved function and quality of life.

Recovery

  • Pain management with prescribed medications.
  • The surgical site should be kept clean and dry as advised.
  • Limited arm movement to allow healing.
  • Physical therapy may be required to restore function.
  • Follow-up appointments for wound assessment and monitoring.

Alternatives

  • Radiation therapy: May be an option for smaller tumors or to shrink the tumor before surgery.
  • Chemotherapy: Employed in cases where the tumor is not resectable or to shrink the tumor preoperatively.
  • Observation: In certain cases, especially in elderly patients with slow-growing tumors.

Patient Experience

Patients will be under general anesthesia and will feel no pain during the procedure. Postoperative discomfort is managed with pain medication. Patients may experience some degree of swelling and limited mobility initially, but these symptoms typically improve with time and rehabilitation.

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