Objective: As vascular surgery migrates toward endovascular treatments, intraoperative consultations offer increasingly rare open surgical experience for trainees. Here we report the experience from vascular surgeons at an independent cancer hospital assisting with exposure, resection, and reconstruction of complex tumors invading the vasculature.Methods: Consultation data for vascular surgery at a tertiary care facility to a stand-alone cancer hospital from October 2003 to September 2016 were retrospectively reviewed. The involvement of the vascular surgeon was reviewed, including need for reconstruction, conduit material, and in-hospital vascular-related complications.Results: There were 128 vascular consultations documented, of which 121 were operative involving 143 total procedures. The majority of consultations involved resection of retroperitoneal and extremity sarcomas (63%), but there were also consultations to assist with colorectal (13%), urologic (7%), gynecologic (6%), thoracic (2%), and head and neck (2%) operations; 63 (52%) operations were planned vascular assist cases in which anticipated need for vascular expertise would likely be warranted. The remainder of operative consultations were called at the time of the operation urgently or emergently. Vascular reconstruction was required in 64 (53%) patients; the remainder of consultations involved exposure, repair, or ligation of large vessels. There were five consultations for isolated thromboembolectomy, one amputation, and one excision of infected vascular prosthetic. In patients receiving arterial reconstruction, 48 (86%) received an anatomic bypass, whereas 8 (14%) received extraanatomic bypasses. Saphenous vein was the most likely conduit used in bypass (53%), followed by polytetrafluoroethylene (27%) and CryoVein (11%; CryoLife, Kennesaw, Ga). The majority (65%) of patients were either undergoing reoperation or had prior irradiation in the surgical field at the time of surgery. Despite this, there were few vascular-related in-hospital complications, including one wound infection requiring resection of graft, one deep venous thrombosis, one early postoperative graft thrombosis, and one pseudoaneurysm. Patients seen by a vascular surgeon preoperatively were no more likely to undergo an autologous reconstruction than those whose intraoperative consultations were unplanned (odds ratio, 0.92; confidence interval, 0.28-3.03).Conclusions: Vascular surgeons can aid in the exposure and play a significant role in the resection and reconstruction for patients undergoing complex oncologic resection throughout the body. In the modern era of surgical training in which surgical subspecialties are exposed to little vascular surgery and vascular surgery trainees are exposed to increasingly dwindling open vascular cases, it becomes advantageous to the surgical oncologists, the vascular surgery trainees, and the patient for vascular surgeons to be involved in these open resections involving vascular exposure and reconstruction.Objective: Many applicants dual appl...
