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10.1245/ASO.2006.04.044
Annals of Surgical Oncology 13:721-727 (2006)
© 2006 Society of Surgical Oncology
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Original Article

Functional Evaluation After Reconstruction With Myocutaneous and Fasciocutaneous Flaps for Conservative Oncological Surgery of the Extremities

Bernardo Rivas, MD1, José F. Carrillo, MD2 and Luis F. Oñate-Ocaña, MD3

1 Plastic Surgery Service, Surgery Division, Instituto Nacional de Cancerologia, San Fernando 22, México D.F. 14080, Mexico
2 Head and Neck Department, Surgery Division, Instituto Nacional de Cancerologia, San Fernando 22, México D.F. 14080, Mexico
3 Clinical Research Division, Instituto Nacional de Cancerologia, San Fernando 22, México D.F. 14080, Mexico

Correspondence: Address correspondence and reprint requests to: Bernardo Rivas, MD; E-mail: berba{at}prodigy.net.mx.

Background: Limb-preservation surgery has evolved during the last two decades through application of pedicled and free flaps and has obtained oncological results similar to those with amputation for malignant neoplasms of the extremities. However, functional evaluation has not been performed comprehensively after these advanced reconstructive procedures. The aim of this study was to describe the oncological, surgical, and functional outcomes achieved in these patients.

Methods: Patients had malignant neoplasms of the extremities and/or shoulder and hip girdle, underwent resective surgery and reconstruction with limb-preservation purposes, and were treated from 1997 to 2002. Survival analysis was performed, and functional evaluation after resection was performed with the Enneking system 1 year after surgery.

Results: Thirty-two patients were included. The mean overall survival of the cohort was 5.6 years. Functional evaluation mean rating percentages for the upper and lower extremities were 86.5% and 75.2%. Functional outcomes were better for reconstruction with free flaps than with pedicled flaps in the lower extremities (rating percentages, 67% and 79.6%, respectively; P = .018).

Conclusions: Limb-preservation surgery is a safe treatment for malignant neoplasms. It can be performed with low morbidity and good oncological outcomes. Functional results in our series were good. Lower limb preservation has superior scores with free flap reconstructions because of their potential to cover extensive defects, and better results were obtained in walking, gait, and weight bearing.

Key Words: Surgical flaps • Limb salvage • Myocutaneous flap • Fasciocutaneous flap






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