Radical resection of tumor; tibia
CPT4 code
Name of the Procedure:
Radical Resection of Tumor; Tibia
Common name(s): Tibial Tumor Resection, Tibial Osteotomy for Tumor.
Summary
Radical resection of a tumor in the tibia involves surgically removing a cancerous growth along with some surrounding bone and tissue to ensure complete removal of the malignant cells. The procedure aims to eliminate the tumor while preserving as much of the leg's function and appearance.
Purpose
The primary purpose is to treat bone cancer located in the tibia (shinbone). It aims to remove the tumor and any affected surrounding tissue to prevent the spread of cancer and reduce the risk of recurrence, ultimately preserving the patient's leg function.
Indications
- Presence of a malignant tumor in the tibia such as osteosarcoma or Ewing's sarcoma.
- Persistent localized bone pain and swelling.
- Radiological evidence of tumor growth.
- Non-responsiveness to non-surgical treatments like chemotherapy or radiation.
Preparation
- Patients may need to fast for 8-12 hours before the procedure.
- Pre-operative blood tests, imaging studies (X-rays, MRI, or CT scans), and biopsy results are required.
- Adjustments or temporary discontinuation of certain medications as advised by the doctor.
- Pre-surgical consultation to discuss anesthesia and evaluate overall fitness for surgery.
Procedure Description
- The patient is given general anesthesia.
- A surgical incision is made over the affected area of the tibia.
- The surgeon carefully resects the tumor and a margin of healthy tissue and bone around it.
- Depending on the extent of bone removed, reconstruction using a bone graft or prosthetic implant may be necessary.
- The surgical site is closed with sutures or staples, and a drain might be placed to remove excess fluids.
- A post-operative dressing and splint or cast may be applied to support the leg during initial recovery.
Duration
The procedure typically takes 2-4 hours, depending on the complexity and extent of the tumor.
Setting
The procedure is performed in a hospital's surgical suite.
Personnel
- Orthopedic oncologist (surgeon).
- Anesthesiologist.
- Surgical nurses.
- Operating room technicians.
Risks and Complications
- Infection at the surgical site
- Blood loss or clotting issues
- Damage to surrounding tissues, nerves, or blood vessels
- Risk of fracture or incomplete removal necessitating further surgery
- Complications from anesthesia
- Potential for tumor recurrence
Benefits
- Complete removal of the tumor, reducing the risk of cancer spreading.
- Alleviation of pain and symptoms associated with the tumor.
- Preservation of limb function and structural integrity when possible.
- Improved overall prognosis and quality of life.
Recovery
- Hospital stay for 5-7 days post-surgery.
- Pain management with prescribed medications.
- Physical therapy to restore limb function and strength.
- Limited weight-bearing activities for 6-12 weeks.
- Follow-up appointments to monitor healing and detect any signs of recurrence.
Alternatives
- Limb-sparing surgery with less extensive resection (less ideal for aggressive or large tumors).
- Amputation in cases of extensive spread or non-viable limbs.
- Radiation or chemotherapy as primary or adjunct treatments (depends on tumor type and stage).
- Pros: Non-surgical treatments might avoid surgical risks; cons: May be less effective in complete tumor eradication.
Patient Experience
During the procedure, the patient will be under general anesthesia and will not feel pain. Post-operative experience may involve pain and discomfort managed by medications. Initial immobility will be followed by gradual physical rehabilitation, and the patient might experience emotional challenges that support from family, friends, or counselors can help address.