Yoshito Tomimaru1,2, Hidetoshi Eguchi1, Hiroshi Wada1,3, Yuichiro Doki1, Masaki Mori1, Hiroaki Nagano4,5. 1. Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan. 2. Department of Gastroenterological Surgery, Toyonaka Municipal Hospital, Toyonaka, Japan. 3. Department of Gastroenterological Surgery, Osaka International Cancer Institute, Osaka, Japan. 4. Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan, hnagano@yamaguchi-u.ac.jp. 5. Department of Gastroenterological, Breast and Endocrine Surgery, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan, hnagano@yamaguchi-u.ac.jp.
Abstract
BACKGROUND/AIM: Inferior vena cava (IVC) resection and reconstruction with concomitant liver resection sometimes represent the only chance for patients with liver tumors involving the IVC to get cured. However, surgical outcomes of liver resection with IVC resection and reconstruction using an artificial vascular graft have not been well investigated. METHODS: Out of a total of 1,179 cases, only 12 involving liver resection between 1998 and 2016 at our institution included IVC resection and reconstruction using an artificial vascular graft. An expanded polytetrafluoroethylene graft was used for the IVC reconstruction in all 12 cases. We investigated the surgical outcomes of these combined surgeries. RESULTS: The median operative time was 650 min and the median blood loss was 2,600 mL. Postoperative complications (≥ grade III in the Clavien-Dindo classification) developed in 2 patients - 1 case of bleeding and one of bile leakage. There were no cases of operative mortality. No complications associated with the vascular graft were observed throughout the postoperative follow-up period, and the grafts remained patent in all cases. CONCLUSIONS: These results indicate favorable surgical outcomes of liver resection combined with IVC resection and reconstruction.
BACKGROUND/AIM: Inferior vena cava (IVC) resection and reconstruction with concomitant liver resection sometimes represent the only chance for patients with liver tumors involving the IVC to get cured. However, surgical outcomes of liver resection with IVC resection and reconstruction using an artificial vascular graft have not been well investigated. METHODS: Out of a total of 1,179 cases, only 12 involving liver resection between 1998 and 2016 at our institution included IVC resection and reconstruction using an artificial vascular graft. An expanded polytetrafluoroethylene graft was used for the IVC reconstruction in all 12 cases. We investigated the surgical outcomes of these combined surgeries. RESULTS: The median operative time was 650 min and the median blood loss was 2,600 mL. Postoperative complications (≥ grade III in the Clavien-Dindo classification) developed in 2 patients - 1 case of bleeding and one of bile leakage. There were no cases of operative mortality. No complications associated with the vascular graft were observed throughout the postoperative follow-up period, and the grafts remained patent in all cases. CONCLUSIONS: These results indicate favorable surgical outcomes of liver resection combined with IVC resection and reconstruction.
Authors: Maria Baimas-George; Christoph Tschuor; Michael Watson; Jesse Sulzer; Patrick Salibi; David Iannitti; John B Martinie; Erin Baker; Pierre-Alain Clavien; Dionisios Vrochides Journal: Langenbecks Arch Surg Date: 2020-09-26 Impact factor: 3.445