Pediatric lower extremity sarcoma reconstruction

A review of limb salvage procedures and outcomes

Merisa Piper, Chetan Irwin, Hani Sbitany

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background In recent years, dramatic advances in the multidisciplinary treatment of pediatric sarcoma have resulted in significant improvement in the long-term survival of the patient. Thus, following tumor resection, significant effort has gone into limb salvage and improving functional outcomes. Plastic surgeons, in conjunction with orthopedic surgeons, are using techniques in microvascular free-tissue transfer and rotational flap surgery to preserve limb length. This study presents a review of the current reconstructive strategies and the oncologic, surgical, and functional outcomes in this population. Methods Using the Pubmed and Cochrane Library databases, studies describing lower extremity plastic surgical reconstruction were identified following pediatric lower extremity sarcoma resection. This study included those studies which described reconstructive techniques, oncologic and functional outcomes, and surgical complications. Results A total of nine articles were identified, yielding 96 pediatric patients. The most common procedures performed were free fibular flaps (53 patients) followed by pedicled muscle flaps (31 patients). A total of 72 of 96 patients (75%) achieved independent ambulation, and an additional 19 patients (20%) ambulated with assistance. There were only three (3%) amputations. A total of 13 patients died from metastatic disease (14%). Conclusions Plastic surgery procedures play an increasingly important role in pediatric lower extremity sarcoma reconstruction and functional limb salvage. Published series are limited in number and case volume; to date, no systematic review has been published. The existing data emphasize the role of microvascular free-fibula transfer as well as local muscle flap coverage in preserving limb length and function, with minimal risk of local recurrence and need for amputation.

Original languageEnglish (US)
Pages (from-to)91-96
Number of pages6
JournalJournal of Plastic, Reconstructive and Aesthetic Surgery
Volume69
Issue number1
DOIs
StatePublished - Jan 1 2016
Externally publishedYes

Fingerprint

Limb Salvage
Sarcoma
Lower Extremity
Pediatrics
Free Tissue Flaps
Amputation
Extremities
Muscles
Fibula
Surgical Flaps
Plastic Surgery
PubMed
Libraries
Walking
Databases
Recurrence
Survival
Population

Keywords

  • Limb salvage
  • Lower extremity reconstruction
  • Pediatric sarcoma
  • Review

ASJC Scopus subject areas

  • Surgery

Cite this

Pediatric lower extremity sarcoma reconstruction : A review of limb salvage procedures and outcomes. / Piper, Merisa; Irwin, Chetan; Sbitany, Hani.

In: Journal of Plastic, Reconstructive and Aesthetic Surgery, Vol. 69, No. 1, 01.01.2016, p. 91-96.

Research output: Contribution to journalArticle

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