Name of the Procedure:

Excision, tumor, soft tissue of thigh or knee area, subfascial (e.g., intramuscular); 5 cm or greater

Summary

This procedure involves surgically removing a tumor located deep within the soft tissue of the thigh or knee area. The tumor is excised from beneath the muscle fascia, and this specific operation is for tumors that are 5 cm or larger in size.

Purpose

This surgical procedure is performed to treat tumors within the muscle layer of the thigh or knee. The primary goal is to completely remove the tumor to prevent its growth or spread, alleviate symptoms, and improve the function and appearance of the affected area.

Indications

• Presence of a soft tissue tumor in the thigh or knee that is 5 cm or greater.
• Symptoms such as pain, swelling, or limited movement.
• Suspicion or confirmation of a malignant tumor.
• Rapid tumor growth or changes in the nature of the tumor.

Preparation

• Fasting for at least 8 hours prior to the procedure.
• Adjustments or cessation of certain medications as advised by the physician.
• Preoperative imaging studies such as MRI or CT scans to determine the exact location and size of the tumor.
• Blood tests and a thorough medical evaluation to assess fitness for surgery.

Procedure Description

1. The patient is administered general anesthesia for full sedation.
2. The surgical site is prepared and sterilized.
3. An incision is made over the affected area of the thigh or knee.
4. The surgeon carefully identifies and separates the layers of muscle and fascia to access the tumor.
5. The tumor is meticulously excised along with a margin of healthy tissue to ensure complete removal.
6. The surgical site is examined for any remaining tumor tissue.
7. Hemostasis is achieved, and the incision is closed with sutures.
8. The wound is dressed, and a sterile bandage is applied.

Duration

Typically, the procedure takes about 1 to 2 hours, depending on the complexity and size of the tumor.

Setting

The procedure is usually performed in a hospital or a specialized surgical center equipped with a sterile operating room.

Personnel

• Surgeon specialized in orthopedic or oncologic surgery.
• Anesthesiologist.
• Surgical nurses and technicians.
• Pathologist (if intraoperative frozen section analysis is needed).

Risks and Complications

• Infection or bleeding at the surgical site.
• Damage to surrounding muscles, nerves, or blood vessels.
• Adverse reactions to anesthesia.
• Scarring and possible wound healing issues.
• Recurrence of the tumor.

Benefits

• Removal of the tumor and reduction in associated symptoms.
• Prevention of tumor growth or spread.
• Improved limb function and cosmetic appearance.
• Peace of mind with the removal of potentially malignant tissue.

Recovery

• Post-surgical pain management with prescribed medications.
• Keeping the surgical site clean and dry.
• Gradual return to normal activities, with specific restrictions as advised.
• Physical therapy may be recommended to restore strength and mobility.
• Follow-up appointments to monitor healing and detect any recurrence.

Alternatives

• Observation and regular imaging for small, asymptomatic tumors.
• Radiation therapy or chemotherapy, particularly if the tumor is malignant and not amenable to complete surgical excision.
• Minimally invasive techniques such as ablation, though these may not be suitable for large or deep tumors.

Patient Experience

• The procedure is performed under general anesthesia, so there is no sensation or discomfort during surgery.
• Postoperative pain and swelling are common and managed with medications.
• Gradual improvement in pain and function over weeks to months post-surgery.
• Supportive care and rehabilitation can greatly aid recovery and overall outcome.