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Chapter 29. Operative Management of Soft Tissue Sarcoma

Dan G. Blazer III, MD; Alfred E. Chang, MD

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    AMA Citation
    Blazer DG, III, Chang AE. Blazer D.G., III, Chang A.E. Blazer, Dan G., III, and Alfred E. Chang.Chapter 29. Operative Management of Soft Tissue Sarcoma. In: Minter RM, Doherty GM. Minter R.M., Doherty G.M. Eds. Rebecca M. Minter, and Gerard M. Doherty.eds. CURRENT Procedures: Surgery New York, NY: McGraw-Hill; 2010. http://accessanesthesiology.mhmedical.com/content.aspx?bookid=419&sectionid=41482843. Accessed September 19, 2018.
    MLA Citation
    Blazer DG, III, Chang AE. Blazer D.G., III, Chang A.E. Blazer, Dan G., III, and Alfred E. Chang.. "Chapter 29. Operative Management of Soft Tissue Sarcoma." CURRENT Procedures: Surgery Minter RM, Doherty GM. Minter R.M., Doherty G.M. Eds. Rebecca M. Minter, and Gerard M. Doherty. New York, NY: McGraw-Hill, 2010, http://accessanesthesiology.mhmedical.com/content.aspx?bookid=419&sectionid=41482843.

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  • Any soft tissue mass that is large or growing should be evaluated by biopsy using the techniques described later.
  • When the diagnosis of sarcoma is established, surgery remains the mainstay of therapy.

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  • Medical comorbidities such as severe cardiopulmonary compromise may preclude safe surgery.

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  • The patient may be placed supine, prone, or in lateral position depending on the location of the lesion.
  • If a soft tissue flap reconstruction is planned, communication with the plastic surgery team is essential when positioning the patient.

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  • Patients are quickly advanced to a regular diet.
  • Activity restrictions vary and depend on the location of surgery and type of plastic surgical reconstruction, if any.

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  • Common complications include surgical site infection, hematoma, seroma, and wound breakdown (especially in previously irradiated tissue).
  • Sarcomas may lie in proximity to major neurovascular structures that may be inadvertently damaged or taken purposefully en bloc with the specimen.
  • Other systemic complications of major surgery (pneumonia, venous thromboembolism, and cardiovascular events) can also occur.

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