Tamil Nadu - Tiruchi   

Limb salvage surgery for bone cancer

By R. Krishnamoorthy

TIRUCHI, SEPT. 17. The Tiruchi-based ABC Hospital claims to have performed a `limb salvage surgery' for bone cancer for the first time in the city. It was performed on a 25-year-old woman, Muthulakshmi.

Unlike as conventional treatment — removal of the limb — , the advanced surgery, by which the bone cancer area was removed and the gap replaced with a `metal custom-made prosthesis', spared the patient trauma.

According to S. Jaikish, orthopaedic surgeon, who led the surgery team, the patient could walk around in the immediate post-operative period. Four months ago Muthulakshmi was diagnosed as suffering from bone cancer (Osteosarcoma) of the distal femur (thigh bone) and her open biopsy report also confirmed it.

However, as she was pregnant at that time, she was put on three cycles of chemotherapy to reduce the vascularity of the tumour and soft tissue reaction around it without terminating the pregnancy. Frequent ultra sonograms were taken after every cycle of chemotherapy to confirm viability of the foetus. The woman was advised to undergo the caesarean section to prevent pathological failure in the bone cancer area.

After she was delivered of a healthy female child, the surgery was performed and the `custom-made total knee replacement prosthesis', made of 1.5 kg stainless steel, fixed to the bone with bone cement. During the five-hour surgery, 11 units of compatible blood were transferred.

Osteosarcoma was dangerous, Dr. Jaikish said. It usually occurred in people between 10 and 20 years before the maturity of the bone. Such patients should be diagnosed once a year after preoperative chemotherapy, surgery and postoperative chemotherapy to rule out `lung secondaries'.

Occurrence of Osteosarcoma in a 25-year-old woman, who had crossed skeletal maturity, was rare, he said.

Dr. Jaikish was assisted in the surgery by Kumaravel, orthopaedic surgeon; Bose, surgical oncologist; and G. Mukhundhan, critical care anaesthesiologist.

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