Name of the Procedure:

Radical Resection of Tumor (e.g., Sarcoma), Soft Tissue of Leg or Ankle Area; 5 cm or Greater

Summary

This procedure involves the surgical removal of a large tumor (5 cm or greater) from the soft tissue in the leg or ankle area. It is a more extensive surgery aimed at eliminating cancerous tumors such as sarcomas to prevent their spread and recurrence.

Purpose

The procedure addresses soft tissue sarcomas, which are a type of cancer arising from connective tissues. The goal is to completely remove the cancerous tissue, reduce the risk of metastasis (spread to other parts of the body), and increase the chances of a cure.

Indications

• Presence of a soft tissue tumor in the leg or ankle area that is 5 cm or greater in size.
• Symptoms such as pain, swelling, or impaired function due to the tumor.
• Confirmation of sarcoma or suspected sarcoma through biopsy or imaging studies.
• Patients fit for major surgery without prohibitive comorbid conditions.

Preparation

• Fasting for at least 8 hours prior to surgery.
• Adjustment or cessation of certain medications as directed by the physician.
• Preoperative imaging studies (MRI, CT scans) to assess the tumor size and location.
• Blood tests to ensure proper organ function and clotting status.

Procedure Description

1. Anesthesia: General anesthesia is administered to ensure the patient is fully unconscious and pain-free.
2. Incision: A surgical incision is made over the tumor site.
3. Tumor Resection: The tumor is carefully dissected from surrounding tissues, aiming to remove it completely with clear margins to ensure no cancerous cells are left behind.
4. Inspection: Surrounding tissues and nodes may be inspected for signs of spread.
5. Closure: The incision is closed using sutures or staples.
6. Postoperative Measures: Drains may be placed to remove excess fluid, and a dressing is applied to protect the wound.

Duration

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

Setting

This procedure is usually performed in a hospital operating room.

Personnel

• Surgeons specialized in oncologic or orthopedic surgery.
• Anesthesiologists.
• Surgical nurses and technicians.
• Pathologist (for tissue examination).

Risks and Complications

• Infection.
• Bleeding or hematoma formation.
• Damage to surrounding structures (nerves, blood vessels, muscles).
• Anesthesia-related risks.
• Recurrence of the tumor.
• Scarring and potential functional loss at the surgery site.

Benefits

• Removal of the cancerous tumor, potentially leading to a cure.
• Reduction in pain and other symptoms caused by the tumor.
• Prevention of tumor spread to other areas of the body. Recovery times and outcomes vary, but patients may start to notice benefits within weeks of the procedure.

Recovery

• Hospital stay of a few days post-surgery for monitoring.
• Pain management with prescribed medications.
• Wound care instructions and possible physical therapy to regain function.
• Follow-up appointments for wound check and to monitor for recurrence.
• Gradual return to normal activities over 4 to 6 weeks.

Alternatives

• Radiation therapy or chemotherapy, either standalone or in combination with surgery.
• Limb-sparing techniques or less radical surgeries for smaller tumors.
• Pros and cons: Surgery provides immediate removal of the tumor, while other treatments may require longer periods and may not be as immediately effective in large tumors.

Patient Experience

During the procedure, the patient is under general anesthesia and will not feel anything. Afterward, they may experience pain and swelling at the incision site, managed by pain medications. Discomfort from the incision and restricted mobility is expected initially, improving gradually with recovery and physical therapy.