The reconstructive stage in the combined treatment of tumors of bones, soft tissues and skin

Introduction. Currently, a personalized approach is considered a priority in the treatment of malignant neoplasms of bones, skin and soft tissues. The decision on the treatment plan is formed by a multidisciplinary team of specialists: a surgeon, a chemotherapist, a radiotherapist. The active introduction of systemic therapy and new technologies in radiation therapy made it possible to ensure local and systemic control of the disease, which contributed to the expansion of indications for performing organ-preserving surgical interventions. In order to improve functional results, while observing the radicality of the intervention, the restoration of integumentary tissues, as well as anatomical structures, is carried out. According to various authors, the need for a reconstructive plastic component in surgical interventions on the musculoskeletal system and skin is 28–32 % for segmental resections of long bones, 30–42 % for operations on pelvic bones, 50–80 % for soft tissue sarcomas, 80 % for operations on the chest wall, when the skin is heated – 44,7 %.

Aim. To study and present the results of combined treatment with reconstructive plastic surgery in patients with tumors of bones, skin and soft tissues.

Materials and methods. The results of treatment and follow-up of 441 patients with locally advanced tumors of the skin, bones and soft tissues who received treatment in Republican Clinical Oncological Dispensary named after Prof. M.Z. Sigal from 2016 to 2023 were analyzed. The patients underwent surgical treatment with the implementation of the reconstructive plastic stage.

Results. In accordance with the principles of a personalized approach, a method of reconstruction of a postoperative defect was chosen for all patients, taking into account the localization of the pathological focus, the volume of surgical intervention, and somatic status.

Conclusion. Performing the reconstructive plastic stage in the surgical treatment of tumors of bones, soft tissues and skin is characterized by a low number of postoperative complications and good functional results, significantly reducing the risk of tumor recurrence and systemic progression due to compliance with the radicality of the intervention.