Retrospective cohort study on pedicled flap reconstruction after trunk soft tissue sarcoma resection: Surgical outcomes and survival analysis.

Abstract

Although pedicled flaps are widely used in trunk reconstruction, evidence remains limited regarding their efficacy in patients with soft tissue sarcoma (STS) requiring wide resection with skeletal involvement. This retrospective cohort study analyzed 42 consecutive patients who underwent pedicled flap reconstruction after trunk sarcoma resection at our institution (2019-2024). Flap types included 30 fasciocutaneous and 12 myocutaneous flaps. Outcomes included flap survival (photographic/Doppler assessment) and complications (Clavien-Dindo). Statistical analysis was performed using the Fisher's exact test and Kaplan-Meier methods (SPSS v26). The cohort demonstrated favorable outcomes with pedicled flap reconstruction (92.86% primary healing rate). Among skeletal defect cases, reconstructions used soft prostheses (n = 6), rigid prostheses (n = 2), or mesh reinforcement (n = 2). During the 11-59 month follow-up period, distant metastases developed in 14.29% of cases (3 pulmonary, 2 hepatic, and 1 peritoneal) (5 pulmonary, 2 pulmonary and hepatic, and 1 peritoneal). Our findings suggest that pedicled flap reconstruction following wide resection of trunk soft tissue sarcomas is associated with satisfactory outcomes (92.9% primary healing rate) and low major complication rates (7.1% Grade I-II complications). These results indicate that pedicled tissue flaps represent a viable reconstructive option when tumor clearance can be achieved.