Surgeons aim to preserve as much of your limb as possible during limb salvage surgery rather than amputating it entirely. Tumors in your arms or legs can be treated with it.
An alternative to total amputation is limb salvage surgery, often known as limb-sparing surgery. It can help treat cancer while preserving the function and appearance of your limb.
Over the past few decades, there has been a significant improvement in the survival rates of individuals with limb cancer. Nowadays, limb salvage surgery is an effective treatment for many people who would have otherwise required an amputation.
Here, we concentrate on limb salvage surgery for cancer, however, surgeons also employ this procedure to treat infections or severe injuries.
Limb salvage surgery purpose
The goal of limb salvage surgery is to treat a tumor while preserving the appearance of your limb. It can be used to treat a variety of cancers, including:
- bone sarcomas such as:
- osteosarcoma
- Ewing sarcoma
- chondrosarcoma
- soft tissue sarcomas like:
- liposarcoma
- leiomyosarcoma
- myxofibrosarcoma
Amputation was the primary surgical treatment for numerous bone malignancies, including osteosarcoma, chondrosarcoma, and Ewing sarcoma, before the 1970s.
The survival rates for certain cancers have considerably increased due to advancements in treatment. Nowadays, limb salvage treatments are used to successfully cure 90% of these cancers.
Types of limb salvage surgery
Autograft, endoprosthesis, bulk allograft, and allograft prosthetic composite repair are the four primary categories of limb salvage operations.
Autograft
When feasible, an autograft is the recommended course of action. To assist replace the tissue that was removed during surgery, a portion of your own body is used as a graft. For instance, your surgeon may utilize bone fragments from your:
- hip
- shin
- rib
It may not be able to do an autograft if you:
- having inadequate blood supply to the operative site
- have serious health issues
- must also undergo radiation treatment in the region.
Endoprosthesis
A prosthetic body part called an endoprosthesis is utilized to replace the one that was removed during surgery. Metal alloys are frequently used to make it. However, there is a failure rate of roughly 25% and a high rate of complications.
Bulk allograft
Large deformities that cannot be repaired with prosthetic reconstruction are treated with bulk allograft. It involves the use of other people’s tissue. This tissue typically derives from cadavers that have just passed away.
Allograft prosthetic composite reconstruction
When compared to an allograft alone, allograft prosthetic composite reconstruction might yield superior functional results. It entails combining prosthetic material with tissue that has been transplanted from another individual.
Limb salvage surgery side effects and risks
There are hazards associated with limb salvage surgery, including:
- infection
- loosening of a prosthetic part
- failure of a graft to bind
- breaking of a graft
- tumor progression
- graft-versus-host disease
Limb salvage surgery success rate
The amount of your cancer and the body part being treated determines the success percentage of salvage surgery. For instance, the 5-year survival rate for replacing the entire femur is approximately 48%, whereas the 5-year survival rate for replacing the upper femur is approximately 88%.
Today, 5-year survival rates have increased from 66% to 82%, and over 90% of cancers are effectively treated with limb salvage surgeries.
Limb salvage procedure
The amount of the malignancy and the area of your body being treated will determine the procedure. Here’s a broad overview of what to anticipate.
Before the procedure
Your physician will explain the possible dangers and what to anticipate before your treatment. You must refrain from eating before your operation. Generally speaking, you should refrain from eating within six hours and drinking within two.
During the procedure
- A little tube will be inserted by a nurse into a vein in your arm or hand. Through this tube, a general anesthetic will be administered to put you to sleep during the procedure.
- Your surgeon will make an incision on your limb while you’re asleep. To ensure that they have removed all of your cancer, doctors will also remove a portion of the surrounding tissue.
- They will use a prosthesis or another kind of graft to replace any bone that was taken.
- Your limb will be rebuilt by your surgeon to preserve its shape and function.
- They will bandage your wounds and close them.
After the procedure
Following your surgery, you will awaken in the recovery area. For monitoring, you will probably need to stay in the hospital for at least a few nights.
Preparing for limb salvage surgery
Before your procedure, you must have a pre-assessment where you will undergo several tests, including:
- general fitness tests
- blood tests
- swab tests to look for infections
- an electrocardiogram and echocardiogram to measure your heart function
- lung function tests
- chest X-ray
- other imaging, such as:
- bone scan
- CT scans
- positron emission tomography (PET)
- MRI
Recovering from limb salvage surgery
A lengthy recuperation period may accompany a significant procedure like limb salvage surgery. Chemotherapy, radiation therapy, and other therapies may be required for weeks to months following your procedure, depending on the type of cancer you have.
After your cancer treatment is over, you’ll probably work with an occupational therapist or physical therapist to help regain your limb’s strength and range of motion. The majority of patients who have surgery to treat soft-tissue sarcoma of the extremities recover to their full potential two to three years later.
Relearning how to walk after lower extremity surgery typically takes a year or so.
Are there any alternatives to limb salvage surgery?
You may require amputation if your cancer is too advanced to be treated with limb salvage surgery. The entire limb is removed during amputation.
If surgery is not possible, radiation therapy may be a substitute.
Limb salvage surgery cost
The cost of limb salvage surgery might differ significantly from one procedure to another. The following things affect the price:
- your geographic location
- the surgical center where you receive your procedure
- the type of procedure needed
- the extent of your procedure
- whether you develop complications
The cost of several operations ranges from tens of thousands to over $100,000.
Medicare and other insurance plans frequently cover all or most of the costs, however, they might not pay for some procedures if they are deemed experimental.
Takeaway
Tumors in your limbs can be treated with limb salvage surgery. This procedure helps maintain the appearance and functionality of your leg as an alternative to amputation. Serious infections and traumatic injuries may also be treated with it.
Limb salvage surgery is now an option for many malignancies that were previously treated with amputation. You can get advice on whether you could be a candidate from your healthcare team.
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