Document Detail


Sciatic nerve reconstruction: limb preservation after sarcoma resection.
MedLine Citation:
PMID:  11324878     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Limb salvage for extremity sarcoma has become the standard of care when possible. This review attempts to determine the outcome of sciatic nerve reconstruction after surgical tumor resection. The authors' objective was to determine the clinical value of extremity salvage with such a defect. Five patients (two male, three female) were selected from a department database at The University of Texas M.D. Anderson Cancer Center between 1995 and 1999 who met the following criteria: lower limb tumor resection involving a gap in the sciatic nerve with subsequent nerve autograft reconstruction. An additional patient who underwent primary sciatic nerve neurorrhaphy was also included. The average tumor size was 203 cm2. The most common tumor histology was spindle cell sarcoma. The average autograft length was 13 +/- 3.2 cm with one to four cables employed. Currently, 3 patients are still alive. Four of the 5 patients who received sciatic autonerve grafts reported partial distal sensory recovery subjectively. The patient who underwent primary neurorrhaphy has both motor and sensory innervation 42 months after surgery. Although not ideal for all patients, sciatic nerve reconstruction is a viable option for those willing to undergo limb preservation. Notable limitations to daily activity do not appear to be present, and patients are able to ambulate with or without assistive devices. With aggressive rehabilitation, some patients are able to function quite well with this bioprosthesis. Patients should consider, however, that their extremity is on loan. Substantial wound complications or infections may ultimately lead to amputation.
Authors:
M Melendez; K Brandt; G R Evans
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Annals of plastic surgery     Volume:  46     ISSN:  0148-7043     ISO Abbreviation:  Ann Plast Surg     Publication Date:  2001 Apr 
Date Detail:
Created Date:  2001-04-27     Completed Date:  2001-08-16     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7805336     Medline TA:  Ann Plast Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  375-81     Citation Subset:  IM    
Affiliation:
Department of Plastic Surgery, The University of Texas, MD Anderson Cancer Center, Houston, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Female
Humans
Leg*
Male
Middle Aged
Movement
Neural Conduction
Peripheral Nerves / transplantation
Postoperative Complications
Recovery of Function
Sarcoma / surgery*
Sciatic Nerve / surgery*
Sensation
Soft Tissue Neoplasms / surgery*
Transplantation, Autologous

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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