Comparative Outcomes of Endoscopic vs Open Surgery for Benign Soft Tissue Lesions
Overview
This propensity score-matched study compared soft-tissue endoscopic surgery (SOFTES) with conventional open surgery (OS) in 150 patients with benign tumors and vascular anomalies. SOFTES demonstrated significantly lower blood loss and fewer wound complications, though operative time was longer. Both approaches showed similar safety profiles with no major complications.
Background
Soft tissue lesions, including benign tumors and vascular anomalies, often require surgical intervention when nonsurgical treatments are insufficient. Traditional open surgery has been associated with longer operative times, larger incisions, and aesthetic concerns due to scarring. Minimally invasive endoscopic techniques (SOFTES) have emerged as alternatives, offering potential benefits such as reduced incisional complications and improved cosmetic outcomes. However, large-scale comparative data between SOFTES and OS have been lacking.
Data Highlights
Parameter
SOFTES (n=75)
OS (n=75)
p-value
Estimated Blood Loss (mL)
20 (1-500)
50 (5-600)
0.001
Operative Duration (minutes)
223 (35-490)
173 (37-494)
0.008
Focal Skin Burn Incidence
Higher
Lower
0.048
Wound Dehiscence
0 (0.00%)
7 (9.33%)
0.010
Flap Necrosis
1 (1.33%)
11 (14.67%)
0.005
Major Complications
None
None
NS
Key Findings
SOFTES resulted in significantly lower estimated blood loss compared to OS (median 20 mL vs. 50 mL; p=0.001).
Operative time was longer in the SOFTES group (median 223 minutes) than in the OS group (median 173 minutes; p=0.008).
Incidence of focal skin burns was higher in SOFTES (p=0.048), but these were minor complications.
Wound dehiscence and flap necrosis rates were significantly higher in the OS group (9.33% and 14.67%, respectively) compared to SOFTES (0% and 1.33%; p=0.010 and p=0.005).
No major complications were observed in either group, and residual pain was effectively managed.
All patients achieved resolution of contracture with normal or near-normal joint motion postoperatively.
Clinical Implications
SOFTES offers a safe and effective minimally invasive alternative to open surgery for selected patients with benign soft tissue tumors and vascular anomalies. The technique reduces intraoperative blood loss and postoperative wound complications, potentially improving cosmetic outcomes. Surgeons should weigh the longer operative time against these benefits when selecting the surgical approach.
Conclusion
Endoscopic surgery represents a paradigm shift in managing benign soft tissue lesions, combining safety and efficacy with reduced postoperative complications. This study supports SOFTES as a valuable option in appropriate clinical scenarios.
Related Resources & Content
Comparative Analysis of Endoscopic and Open Surgical Techniques for Benign Tumors and Vascular Anomalies: A Propensity Score-Matched Study Across Two Centers
