What are the implications of sartorius muscle resection?

Implications of Sartorius Muscle Resection

Sartorius muscle resection generally has minimal functional impact on limb mobility and strength when performed as part of oncologic surgery, as the muscle's function can be compensated by other muscles in the thigh. 1

Functional Considerations

• The sartorius muscle plays a role in hip flexion, external rotation, and knee flexion, but its resection typically results in minimal functional deficits due to compensation by other muscles 1
• Patients may experience initial impairment in hip flexor function, but functional deficit becomes negligible with time and rehabilitation 2
• Sartorius muscle is considered expendable in certain clinical scenarios, making it suitable for transfer procedures without significant long-term functional consequences 3

Oncologic Context

• In soft tissue sarcoma management, sartorius resection may be necessary to achieve negative margins while preserving limb function 1
• The goal of surgery for extremity sarcomas should be functional limb preservation within the realm of appropriate oncologic resection 1
• Radical excision or entire anatomic compartment resection is not routinely necessary, allowing for preservation of neurovascular structures when not directly involved with tumor 1

Surgical Considerations

• When sartorius resection is performed, the surgical margins should be documented by both the surgeon and pathologist to ensure adequate tumor clearance 1
• If surgical margins are positive after resection (except when involving bone, nerve, or major blood vessels), re-resection should be considered if it won't significantly impact functionality 1
• Preoperative evaluation for rehabilitation (physical therapy, occupational therapy) is recommended for patients undergoing extremity sarcoma surgery involving muscle resection 1

Alternative Uses of Sartorius Muscle

• The sartorius muscle can be used beneficially in various reconstructive procedures:
  • As a myoplasty for infected vascular grafts in the groin with high success rates (100% wound healing and limb salvage in one study) 2
  • For transfer to reinforce quadriceps function in cases of quadriceps tendon rupture, with good functional outcomes 4
  • In nerve transfer procedures, as sartorius branches are often spared in femoral nerve injuries 3

Postoperative Considerations

• Rehabilitation should continue until maximal function is achieved 1
• Sarcopenia (loss of muscle mass) is associated with increased risk of surgical site infections and postoperative complications, highlighting the importance of physical rehabilitation 1
• Peri-operative physical rehabilitation programs should be multidimensional and adapted to patients' baseline characteristics 1

Potential Complications

• Muscle resection may contribute to sarcopenia, which is associated with higher postoperative complication rates 1
• Wound complications can occur following sartorius muscle procedures, with reported 30-day complication rates of approximately 28% in one study 5
• Careful surgical technique and appropriate rehabilitation can minimize these complications 1