Single Stage Oncologic Resection and Reconstruction: A Step toward Development of Sarcoma Service in Resource Constrained Country*

Copyright © 2013 Haroon ur Rashid et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Tumor free-margin surgical resection remains the single most important treatment in the curative therapy of muscu-loskeletal tumor of limbs. Refinements in surgical techniques have led to increased function preservation and limb sal-vage. Patients and Methods: The records of patients (n = 24) who underwent microsurgical soft tissue reconstruction subsequent to resection of limb tumour during the period 2006 to 2011 were reviewed. Primary outcome i.e. uptake of the flap was evaluated. Perioperative morbidities were also noted including donor as well as recipient site complications. Assessment of Functional outcome (Musculoskeletal Tumor Society score, MSTS) local recurrence, free survival, and disease-specific survival was also made. Results: Twenty four patients (age range: 7- 72 years) who have undergone tumor resection followed by flap coverage were identified. Lower limb reconstruction outnumbered upper limb by 6:1. Complications included, one complete failure of free vascularized iliac crest flap done for reconstruction of a heel de-fect. One of the patients had secondary hemorrhage 10 days after surgery. Another patient with internal hemipelvec-tomy for Ewing’s sarcoma had a dura puncture during resection of sacrum. Partial epidermal necrosis was evident in four cases. Eighty three percent of the patients remained alive (n = 20), 19 of whom currently have no evidence of dis