Name of the Procedure:

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

Summary

This surgical procedure involves the removal of a tumor from the soft tissues located in the leg or ankle area. The term "subfascial" indicates that the tumor is under the fascial layer, often within the muscles. This specific description covers tumors that are 5 cm or larger in size.

Purpose

This procedure aims to remove benign or malignant tumors from the soft tissues of the leg or ankle. By excising the tumor, the procedure seeks to alleviate symptoms, prevent further growth, and reduce the risk of metastasis in malignant cases.

Indications

• Presence of a palpable mass or swelling in the leg or ankle area.
• Pain, discomfort, or functional impairment due to the tumor.
• Diagnosis of a soft tissue tumor (e.g., via imaging or biopsy) showing potential for malignancy or significant growth.
• Failure of non-surgical treatments to manage symptoms.

Preparation

• Fasting for at least 8 hours before the surgery.
• Adjustments to medications as instructed by the healthcare provider (e.g., stopping blood thinners).
• Preoperative assessments including blood tests, imaging studies (MRI, CT scan), and possibly a biopsy to confirm the diagnosis.

Procedure Description

1. The patient is positioned and prepped in a sterile surgical environment.
2. Anesthesia is administered—usually general anesthesia.
3. The surgeon makes an incision over the site of the tumor.
4. The fascial layer is carefully dissected to reach the tumor, which is then excised with surrounding healthy tissue to ensure complete removal.
5. The surgical site is irrigated, and hemostasis is achieved.
6. The fascial layer and skin are sutured closed.
7. A dressing is applied to the incision site.

Duration

The procedure typically takes between 1 to 2 hours, depending on the tumor's size and location.

Setting

This procedure is usually performed in a hospital or surgical center equipped with the necessary facilities for anesthesia and postoperative care.

Personnel

• Surgeon specialized in orthopedic or oncologic surgery.
• Anesthesiologist or nurse anesthetist.
• Surgical nurses and/or technicians.
• Pathologist (for intraoperative or postoperative evaluation of the tumor).

Risks and Complications

• Common: Infection, bleeding, pain, or bruising at the surgical site.
• Rare: Nerve damage, vascular injury, incomplete tumor removal, recurrence of the tumor.

Benefits

• Removal of the tumor can relieve symptoms such as pain and swelling.
• Reduced risk of tumor growth or spread, particularly in malignant cases.
• Potentially improved function and mobility of the affected leg or ankle area. Benefits typically become noticeable within weeks after recovery.

Recovery

• Postoperative care involves keeping the surgical site clean and dry.
• Follow-up appointments to monitor healing and remove sutures.
• Physical activity may be limited for several weeks.
• Pain management with prescribed medications.
• Physical therapy may be recommended to restore function and strength.

Alternatives

• Observation and regular monitoring of the tumor if it's benign and asymptomatic.
• Radiation therapy or chemotherapy, especially in cases of malignant tumors.
• Minimally invasive procedures like radiofrequency ablation, depending on tumor location and type.
• Each alternative has different potential benefits and risks, depending on individual patient factors.

Patient Experience

• The patient will be under general anesthesia and will not feel pain during the procedure.
• Some pain and discomfort can be expected postoperatively, managed with pain relievers.
• Swelling and bruising are common but should subside in a few weeks.
• Patients might feel fatigued and require assistance with daily activities initially.
• Follow-up care is essential for a full recovery and monitoring for potential complications.