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

Abstract

<h4>Background and objective</h4>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.<h4>Methods</h4>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).<h4>Results</h4>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).<h4>Conclusion</h4>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.