Risk factor for wound complications following wide resection of soft tissue sarcoma in the adductor compartment of the thigh

Author:

Kito Munehisa1,Ae Keisuke2,Koyanagi Hirotaka3,Gokita Tabu4,Furuoka Hideto4,Okamoto Masanori1ORCID,Tanaka Atsushi1,Suzuki Shuichiro1,Takazawa Akira5,Aoki Kaoru1,Yoshimura Yasuo5

Affiliation:

1. Department of Orthopaedic Surgery, Shinshu University School of Medicine

2. Department of Orthopaedic Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research

3. Department of Orthopaedic Surgery, Tokyo Medical and Dental University

4. Department of Orthopaedic Surgery, Saitama Cancer Center

5. Department of Orthopaedic Surgery, Shinshu Ueda Medical Center

Abstract

Abstract Background The purpose of this study was to investigate deep-seated soft tissue sarcoma (STS) occurring in the adductor compartment of the thigh that underwent wide resection and to clarify the high-risk group for wound complications. Patients and methods From 2000 to 2017, we reviewed 104 cases of deep-seated STS occurring in the adductor compartment of the thigh that were treated at four specialized facilities with expertise in sarcoma treatment. Results Wound complications occurred in 40 cases (38.5%), of which 23 cases (22.1%) were cases with major wound complications (MWC). In univariate analysis, BMI (P < 0.01), maximum tumor diameter (P < 0.01), operation time (P < 0.01), amount of intraoperative bleeding (P < 0.01), and intraoperative intervention to the femoral artery and vein (P < 0.01) were significantly associated with wound complications. In multivariate analysis, the associated parameters were BMI (P < 0.01), maximum tumor diameter (P = 0.02), and intraoperative intervention to the femoral artery and vein (P = 0.01). When limited to cases with MWC, univariate analysis showed that maximum tumor diameter (P < 0.01), diabetes mellitus (P = 0.03), operation time (P < 0.01), amount of intraoperative bleeding (P < 0.01), and intraoperative intervention to the femoral artery and vein (P = 0.02) were significantly associated parameters. In multivariate analysis, maximum tumor diameter (P = 0.02) and amount of intraoperative bleeding (P = 0.04) were associated parameters. Conclusions For patients with risk factors for wound complications, control of bleeding are crucial when resecting deep-seated STS in the adductor compartment of the thigh. In cases with large tumors, surgeons should be especially cautious of cases requiring interventions that surround the femoral artery and vein in order to attain an appropriate surgical margin.

Publisher

Oxford University Press (OUP)

Subject

Cancer Research,Radiology, Nuclear Medicine and imaging,Oncology,General Medicine

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