The free innervated latissimus dorsi flap for functional reconstruction following soft tissue sarcoma resection of the posterior compartment of the thigh
- 3 Downloads
Soft tissue sarcoma (STS) surgery has evolved significantly over the last half a century. From amputation to limb-salvage and limb-sparing surgery, reconstructive demands have continuously increased in an effort to provide the best function-preserving disease-free outcome. Given STS typically affect the limbs more so than any other region of the body, restoration of function whilst not important oncologically is critical to incorporate in the reconstructive plan of any onco-plastic team. The use of loco-regional flaps as well as free flaps provides the mainstay of reconstructive options. The next advance in the reconstructive journey in this clinical area is the use of innervated flaps to restore function.
Between 2011 and 2016, all patients who underwent sarcoma extirpation from the posterior thigh and reconstruction using a free innervated latissimus dorsi flap were prospectively identified and a case note review was performed.
In this series, 7 patients have undergone free flap reconstruction of the thigh posterior compartment achieving MRC (medical research council, UK) grade M5 power restoration in 6/7 patients.
The authors believe this technique to be hugely valuable in the surgical armamentarium of the reconstructive plastic surgeon in order to achieve the best functional outcomes in such a cohort of patients.
Level of Evidence: Level IV, therapeutic study.
KeywordsInnervated flap Latissimus dorsi Hamstring reconstruction Functional reconstruction Sarcoma reconstruction
Compliance with ethical standards
All of the patients have given consent.
Conflict of interest
Damien Grinsell and Zeeshan Ahmad declare that they have no conflict of interest.
Gained from the Local Quality Assurance Sub-committee of the Human Research and Ethics Committee (Reference: QA 057/16).
The authors received no funding in production of this paper.
- 1.Australian Institute of Health and Welfare; Australasian Association of Cancer Registries (2001) Cancer in Australia 1998: Incidence and mortality data for 1998. Cancer series no. 17. AIHW cat. no. CAN 12. [cited 2008 Dec 12]. Available from: www.aihw.gov.au/publications/can/ca98/
- 2.Begg S, Vos T, Barker B, Stevenson C, Stanley L, Lopez AD (2007) The burden of disease and injury in Australia 2003. Canberra: Australian Institute of Health and Welfare. [cited 2007 Nov 14]. Available from: http://www.aihw.gov.au/publications/hwe/bodaiia03/bodaiia03-c00.pdf
- 3.Australian Institute of Health and Welfare (2005) Health and Welfare Expenditure Series Number 22: Health system expenditures on cancer and other neoplasms in Australia, 2000–01. Canberra: Australian Institute of Health and Welfare. [cited 2007 Nov 14]. Available from: http://www.aihw.gov.au/publications/hwe/hsecna00-01/hsecna00-01.pdf
- 9.Enneking WF, Spanier SS, Goodman MA (1980) A system for the surgical staging of musculoskeletal sarcoma. Clin Orthop Relat Res (153):153–154Google Scholar
- 12.Grinsell D, Di Bella C, Choong P, Functional reconstruction of sarcoma defects utilising innervated free flaps, Sarcoma, 2012, 315190, 26Google Scholar
- 17.Yasko A, Patel R, Pollack A, Pollack RE (eds) (2001) Sarcomas of soft tissue and bone. Atlanta: American Cancer SocietyGoogle Scholar