What are the Primary Goals of Limb Salvage Surgery?

The surgery carried out to remove bone cancer and soft tissue in the limbs is called limb salvage surgery.

The procedure is also otherwise known as limb-sparing surgery and is often done to avoid amputation.

Limb Salvage Surgery

Essentially, the key goals of the procedure include:

  • Removing the cancer cells
  • Avoiding amputation
  • Maintaining the affected limb’s greatest degree of function
  • Preserving the patient’s appearance

While limb-sparing surgery is often only carried out in the case of sarcomas and tumors, it is also done when there are soft tissue sarcomas that affect the extremities.

Understandably, it has become the preferred option over amputation over the years.

It is also the procedure often resorted to for cancers that have not invaded the soft tissues yet.

Years prior, typical treatment intervention for individuals with cancer in the limbs has been amputation of the affected extremity.

Fortunately, with limb salvage surgery, there is an option to treat the cancer without losing the limb.

This development is also credited to other key factors like current imaging method available (MRI and CT scans), surgical technique enhancements (reconstruction and resection), and survival rate of patients treated with chemotherapy.

Nowadays, limb salvage surgery has also become the likely option for those patients with chronic degenerative joint conditions and bone diseases.

Likewise, it is also considered a treatment intervention for candidates of diabetic limb amputation.

Key Considerations

Before limb-sparing surgery is recommended, several key factors are taken into account, including:

  • The type of cancer
  • The location of the cancer
  • The overall health of the patient
  • The patient’s age
  • The size of the cancer
  • The progression of the condition

If the procedure is recommended, the likely outcome will be explained including the possibility of an implant failure.

Also, in the event of an implant failure, further surgery or even amputation may be required.

Occupational and physical therapists will also help prepare likely candidates for limb salvage surgery through ambulation (walking) and muscle-strengthening exercises.

Range of motion (ROM) exercises will also be likely taught.

Procedure Overview

Limb salvage surgery involves removal of the cancer as well as an inch of the healthy tissues surrounding it.

Radiation, chemotherapy, or both might be recommended prior to the surgery in order to shrink the tumor.

Essentially, the procedure has 3 stages:

  • Removal of the cancer as well as a margin of healthy tissue.
  • Bone graft is done or prosthesis is implanted when needed.
  • Wound is closed utilizing soft muscle or tissue from other parts of the body.

Surgical Techniques

Bone tumors – treatment intervention for low-grade bone tumors and its components involve cutting off the malignant lesion and a cuff of healthy tissue.

Soft tissue sarcomas – at least 80 percent of soft tissue sarcomas that affect the extremities are treated using limb salvage surgery. The procedure will also involve removal of the tumor and the lymph nodes. Tissues where the cancer has spread will be removed also.

If the soft tissue sarcoma has already spread to the lung, the original tumor will be removed first. The lung tumor will be shrank using radiation or chemotherapy before the lung tumor will be removed.

Post-Surgery Care

After the procedure, patient will remain in the hospital for at least 5 to 10 days.

Blood flow and sensation of the extremity affected will be closely monitored.

Likely signs of complications like pneumonia, pulmonary embolism, and deep-vein thrombosis will also be checked.

In the first 48 hours, broad spectrum antibiotics will be given. Medications (prophylactic anticoagulants) and anti-embolism stockings will also be given.

Also, a drainage tube will be placed in the wound to avoid fluid and blood accumulation.

Charles A William