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Limb-Saving Surgery Using In Situ Preparation (ISP) Method

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Osteosarcoma

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Abstract

Background: In situ preparation (ISP) makes it possible to intraoperatively prepare the neurovascular bundle and eventually evaluate the surgical margin without contamination of tumor cells. ISP was applied to locally advanced osteosarcoma of distal femur for limb salvage.

Methods: The tumor and femoral vessels are lifted en bloc from the surgical bed and separated from the operation field by the use of a vinyl sheet. The consistency of the vessels is preserved. The en bloc mass can be freely turned around and the femoral vessels are separated from the block through the nearest approach. The margin between the tumor and femoral vessels is evaluated and an additional procedure, such as alcohol soaking or distilled water soaking, is performed.

Results: Seven cases with locally advanced osteosarcoma of distal femur were operated on using this method. No local recurrences were found.

The advantage of ISP is no risk of contamination of tumor cells. Because there is no need of special equipment, this procedure can be easily done throughout the world.

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References

  1. Matsumoto S, Kawaguchi N, Manabe J, Matsushita Y. “In situ preparation”: new surgical procedure indicated for soft-tissue sarcoma of a lower limb in close proximity to major neurovascular structures. Int J Clin. 2002;7:51–6.

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  2. Kawaguchi N, Ahmed AR, Matsumoto S, Manabe J, Matsushita Y. The concept of curative margin in surgery for bone and soft tissue sarcoma. Clin Orthop. 2004;419:165–72.

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Authors and Affiliations

  1. Department of Orthopedic Oncology, Cancer Institute Ariake Hospital, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan

    Seiichi Matsumoto M.D., Ph.D. & Keisuke Ae M.D., Ph.D.

Authors
  1. Seiichi Matsumoto M.D., Ph.D.
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  2. Keisuke Ae M.D., Ph.D.
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Corresponding author

Correspondence to Seiichi Matsumoto M.D., Ph.D. .

Editor information

Editors and Affiliations

  1. Osaka National Hospital, Osaka University, Osaka, Osaka, Japan

    Takafumi Ueda

  2. National Cancer Center Hospital, Tokyo, Tokyo, Japan

    Akira Kawai

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Matsumoto, S., Ae, K. (2016). Limb-Saving Surgery Using In Situ Preparation (ISP) Method. In: Ueda, T., Kawai, A. (eds) Osteosarcoma. Springer, Tokyo. https://doi.org/10.1007/978-4-431-55696-1_17

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  • DOI: https://doi.org/10.1007/978-4-431-55696-1_17

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  • Publisher Name: Springer, Tokyo

  • Print ISBN: 978-4-431-55695-4

  • Online ISBN: 978-4-431-55696-1

  • eBook Packages: MedicineMedicine (R0)

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