RESUMEN
OBJECTIVES: To describe the lateral approach to the popliteal artery in reconstructions after soft tissue sarcoma resection in the thigh. DESIGN: Case reports. Subjects Four patients with soft tissue sarcoma. METHODS: Extraanatomic reconstruction of the resected artery and vein in the medial part of the thigh was performed. Vessel reconstruction was performed before tumor resection to avoid leg ischemia. RESULTS: In all four patients the artery was replaced by using the contralateral saphenous vein, while the femoral vein was replaced in two cases using e-PTFE. Post-operative complications included one large lymphatic collection and a deep wound infection. Arterial primary graft patency was 100% after 1-7 years. Patency of the e-PTFE-venous graft was 0% without further consequences. CONCLUSIONS: The extraanatomic lateral replacement of the vessels in the thigh is an elegant method in difficult vascular reconstructions after soft tissue sarcoma resection or debridement for deep vascular infections.
Asunto(s)
Arteriopatías Oclusivas/cirugía , Arteria Femoral/cirugía , Procedimientos de Cirugía Plástica/métodos , Arteria Poplítea/cirugía , Adulto , Anciano , Arteriopatías Oclusivas/diagnóstico , Arteriopatías Oclusivas/etiología , Prótesis Vascular , Implantación de Prótesis Vascular/instrumentación , Arteria Femoral/diagnóstico por imagen , Arteria Femoral/patología , Estudios de Seguimiento , Humanos , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Politetrafluoroetileno , Arteria Poplítea/diagnóstico por imagen , Arteria Poplítea/patología , Diseño de Prótesis , Reoperación , Vena Safena/trasplante , Sarcoma/diagnóstico , Sarcoma/cirugía , Infección de la Herida Quirúrgica/complicaciones , Infección de la Herida Quirúrgica/diagnóstico , Ultrasonografía Doppler DúplexRESUMEN
OBJECTIVES: to determine whether application of fibrin glue before closure of inguinal wounds reduces the incidence of lymphatic complications. DESIGN: we a prospective randomised trial. MATERIALS AND METHODS: 224 consecutive patients were enrolled. The wounds were randomly assigned to standard closure (group A, n = 134) or closure with application of fibrin glue (group B, n = 132). The incidence of local lymphatic and non-lymphatic complications, the amount of lymphatic fluid collected, and the time to drain removal were compared in the groups. RESULTS: the incidence of lymphatic complications was 19% in group A and 10% in group B (p = 0.027). The average drain output and the time to drain removal did not differ in the two groups. The total incidence of non-lymphatic local complications was 10% and did not differ in the two groups. CONCLUSIONS: fibrin glue application is associated with a significant reduction in lymphatic complications.