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SOFT TISSUE ONCOLOGY
Retroperitoneal Tumour Resection
Complex surgery for large tumours of the retroperitoneum — including liposarcoma and leiomyosarcoma — requiring extended resection, multivisceral en-bloc excision, and vascular reconstruction.
ABOUT THE PROCEDURE
Aggressive Surgery for Retroperitoneal Sarcomas
Retroperitoneal tumours — most commonly liposarcoma and leiomyosarcoma — are rare but challenging malignancies that grow to large sizes within the retroperitoneal space before causing symptoms. Complete surgical resection with wide clear margins is the primary treatment and the most important predictor of outcome.
Because of the intimate relationship of retroperitoneal sarcomas with major vessels (aorta, inferior vena cava, iliac vessels), adjacent organs (kidney, colon, pancreas), and nerves, resection often involves en-bloc removal of contiguous organs to achieve clear margins. This extended multivisceral resection philosophy has been shown to reduce local recurrence rates.
Surgery for retroperitoneal sarcoma requires meticulous pre-operative planning with high-quality cross-sectional imaging and an experienced surgical oncology team comfortable with both major retroperitoneal dissection and vascular reconstruction when needed.
How It Is Performed
Pre-operative Planning
Multi-phasic CT with vascular reconstruction mapping, MRI for soft tissue characterisation. MDT review at specialist sarcoma centre. Core needle biopsy for histological diagnosis and grading.
Extended Retroperitoneal Dissection
Wide exposure through midline laparotomy. Systematic dissection freeing the tumour from retroperitoneal structures. Medial visceral rotation for access to major vessels.
En-bloc Multivisceral Resection
Contiguous organs (kidney, colon, psoas muscle, adrenal gland) resected en-bloc with tumour to achieve a macroscopic R0 margin. Vascular resection/reconstruction if IVC/iliac involved.
Reconstruction & Oncological Follow-up
Bowel or urological reconstruction as required. Post-op CT surveillance at 3–4 monthly intervals given high local recurrence risk. Radiation considered for selected high-grade sarcomas.
CANDIDACY
Who May Benefit?
Primary retroperitoneal liposarcoma
Well-differentiated and dedifferentiated liposarcoma — the commonest retroperitoneal sarcoma. Surgery is primary treatment; radiation may supplement for dedifferentiated histology.
Retroperitoneal leiomyosarcoma
Arising from smooth muscle of major vessels or the retroperitoneum. Systemic chemotherapy (doxorubicin-based) may be considered for high-grade disease before or after resection.
Extragonadal germ cell tumours
Retroperitoneal residual masses following chemotherapy for metastatic testicular cancer are resected by retroperitoneal lymph node dissection (RPLND).
Other retroperitoneal masses
Paragangliomas, nerve sheath tumours, and other rare retroperitoneal tumours require specialist surgical evaluation for resectability.
AIIMS TRAINING · SOFT TISSUE ONCOLOGY
Complex Soft Tissue Tumour Surgery
Dr. Imaduddin trained in soft tissue and retroperitoneal tumour surgery at AIIMS, one of the few centres in India with a dedicated multidisciplinary sarcoma programme and high-volume retroperitoneal surgery experience.
Consult Dr. Imaduddin for Retroperitoneal Tumour Surgery
Retroperitoneal tumours require specialist evaluation before surgery. Dr. Imaduddin provides expert consultation for complex retroperitoneal and soft tissue tumours in Hyderabad.