Masato Yoshioka1, Hiroshi Uchinami2, Go Watanabe2, Masatake Iida2, Yasuhiko Nakagawa2, Hideaki Miyazawa2, Makoto Yoshida3, Yuzo Yamamoto2. 1. Department of Gastroenterological Surgery, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan. masato@gipc.akita-u.ac.jp. 2. Department of Gastroenterological Surgery, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan. 3. Department of Cellular and Organ Pathology, Akita University Graduate School of Medicine, Akita, Japan.
Abstract
BACKGROUND: In the portal vein resection of long distance, an interposition by autologous vein is mandatory. External iliac vein (EIV) has been used, but harvesting the EIV is associated with severe venous congestion of the affected lower extremity. We have reconstructed the EIV using a ringed expanded polytetrafluoroethylene (ePTFE) graft. METHODS: Thirteen patients underwent this surgery. The right EIV was used for reconstructing the portal vein, and the retrieved portion of EIV was interposed by the ePTFE graft. We evaluated size and length of the graft, graft patency, girth of thigh, time for reconstruction of EIV, and graft infection. RESULTS: ePTFE grafts of 8 or 10 mm in diameter were used. The length of ePTFE graft used was 4.4 ± 0.5 cm. Graft patency was kept in 76.9% patients. Graft obstruction was encountered in three patients, and the girth of right thigh increased by about 10 cm. Time for reconstruction of EIV was 29.5 ± 6.8 min. Graft infection did not occur in any patients. CONCLUSIONS: Reconstruction of the EIV using a ringed ePTFE graft seems to be a feasible option for preventing the swelling of the affected lower extremity after procurement of EIV for repairing the portal vein.
BACKGROUND: In the portal vein resection of long distance, an interposition by autologous vein is mandatory. External iliac vein (EIV) has been used, but harvesting the EIV is associated with severe venous congestion of the affected lower extremity. We have reconstructed the EIV using a ringed expanded polytetrafluoroethylene (ePTFE) graft. METHODS: Thirteen patients underwent this surgery. The right EIV was used for reconstructing the portal vein, and the retrieved portion of EIV was interposed by the ePTFE graft. We evaluated size and length of the graft, graft patency, girth of thigh, time for reconstruction of EIV, and graft infection. RESULTS:ePTFE grafts of 8 or 10 mm in diameter were used. The length of ePTFE graft used was 4.4 ± 0.5 cm. Graft patency was kept in 76.9% patients. Graft obstruction was encountered in three patients, and the girth of right thigh increased by about 10 cm. Time for reconstruction of EIV was 29.5 ± 6.8 min. Graft infection did not occur in any patients. CONCLUSIONS: Reconstruction of the EIV using a ringed ePTFE graft seems to be a feasible option for preventing the swelling of the affected lower extremity after procurement of EIV for repairing the portal vein.
Authors: J S Lindholt; B Gottschalksen; N Johannesen; D Dueholm; H Ravn; E D Christensen; B Viddal; T Flørenes; G Pedersen; M Rasmussen; M Carstensen; N Grøndal; H Fasting Journal: Eur J Vasc Endovasc Surg Date: 2011-03-03 Impact factor: 7.069
Authors: Jennifer F Tseng; Chandrajit P Raut; Jeffrey E Lee; Peter W T Pisters; Jean-Nicolas Vauthey; Eddie K Abdalla; Henry F Gomez; Charlotte C Sun; Christopher H Crane; Robert A Wolff; Douglas B Evans Journal: J Gastrointest Surg Date: 2004-12 Impact factor: 3.452