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The Use of ECMO and Free-Fillet-Leg Flap for Complex Pelvic Reconstruction: A Case Report.
Cigna, Emanuele; Bolletta, Alberto; Pozzi, Mirco; Schettino, Michela; Mani, Olimpia; Andreani, Lorenzo; Boggi, Ugo; Capanna, Rodolfo.
Afiliación
  • Cigna E; Plastic Surgery Unit, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy.
  • Bolletta A; Plastic Surgery Unit, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy.
  • Pozzi M; Unit of Plastic and Reconstructive Surgery, Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy.
  • Schettino M; From the Service de Chirurgie Plastique, Hôpital Erasme, Brussels, Belgium.
  • Mani O; Department of Orthopaedics and Trauma Surgery, University of Pisa, Pisa, Italy.
  • Andreani L; Department of Orthopaedics and Trauma Surgery, University of Pisa, Pisa, Italy.
  • Boggi U; Division of General and Transplant Surgery, University of Pisa, Pisa, Italy.
  • Capanna R; Department of Orthopaedics and Trauma Surgery, University of Pisa, Pisa, Italy.
Microsurgery ; 44(6): e31234, 2024 Sep.
Article en En | MEDLINE | ID: mdl-39240030
ABSTRACT
Advanced sarcoma treatment in complex anatomical regions such as the pelvis poses significant surgical challenges. This report details a case involving a 35-year-old man with recurrent osteosarcoma of the left hemipelvis, who underwent a 16 h surgery for hemipelvectomy and reconstruction using a free tibia and fibula fillet leg flap. The procedure, necessitated by an infected, exposed iliac prosthesis, utilized extracorporeal membrane oxygenation (ECMO) for 8 h to maintain flap viability. The flap, incorporating tibia, fibula, and associated musculature was successfully inset and anastomosed to the left common iliac artery and vein, with additional venous anastomosis to the right iliac vein. Despite postoperative challenges such as venous stasis and intestinal ischemia, necessitating further surgical interventions, the patient achieved mobility with a walker at 3 months post-surgery, with stable conditions observed during a 2 years follow-up. ECMO enabled successful preservation and integration of the free fillet leg flap, demonstrating its potential in complex reconstructive surgeries. Specifically, ECMO may extend free flap viability in complex cases, offering new possibilities for challenging oncological and reconstructive surgeries.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Óseas / Oxigenación por Membrana Extracorpórea / Osteosarcoma / Procedimientos de Cirugía Plástica / Colgajos Tisulares Libres / Hemipelvectomía Límite: Adult / Humans / Male Idioma: En Revista: Microsurgery Año: 2024 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Óseas / Oxigenación por Membrana Extracorpórea / Osteosarcoma / Procedimientos de Cirugía Plástica / Colgajos Tisulares Libres / Hemipelvectomía Límite: Adult / Humans / Male Idioma: En Revista: Microsurgery Año: 2024 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Estados Unidos