Inferior vena cava resection and reconstruction for retroperitoneal tumor excision

Quiñones-Baldrich, William J.; Alktaifi, Ali; Eilber, Fritz C.; Eilber, Frederick R.

doi:10.1016/j.jvs.2011.11.054

Cited by 111 publications

(101 citation statements)

References 14 publications

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“…In particular, the optimal management of the IVC after resection is debatable, with some advocating ligation, 14,30 others selective, 12,31,32 and others routine reconstruction. 11,13,16,18 The rationale for the latter is based on the need to resect several venous collaterals for complete tumor removal, as well as the inability to predict which patients will tolerate IVC ligation without subsequent renal insufficiency or significant lower extremity edema. Our study was not designed to address this specific question.…”

Section: Discussionmentioning

confidence: 99%

“…Over the last decade, several case series have established the feasibility and safety of en bloc vascular resection for sarcomas of the extremity, [3][4][5][6][7] retroperitoneum, [8][9][10] or specifically the inferior vena cava (IVC). [11][12][13][14][15][16][17][18] What remains unknown is whether these complex procedures are associated with a durable prolongation of survival that justifies their morbidity. Our institution has previously reported our findings with major blood vessel reconstruction on 14 sarcoma patients undergoing surgical resection.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Sarcoma Resection With and Without Vascular Reconstruction: A Matched Case-Control Study

Poultsides¹,

Tran²,

Zambrano³

2015

Journal of Vascular Surgery

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Sarcoma Resection With and Without Vascular Reconstruction: A Matched Case-Control Study

Poultsides¹,

Tran²,

Zambrano³

2015

Journal of Vascular Surgery

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“…In the presented case, surgical resection was initially deferred due to encasement of the aorta, IVC, origins of the superior mesenteric artery and bilateral renal arteries. Previously, complete resection of the tumor with reconstruction of major vascular structures was shown to be a safe method with acceptable outcome for complete resection of large retroperitoneal tumors including sarcoma (19)(20)(21)(22). However, even in these studies, nephrectomy appeared to be inevitable in order to meet the oncological standards of complete resection (20,22).…”

Section: Discussionmentioning

confidence: 99%

Ex vivo excision of retroperitoneal soft tissue tumors: A case report

Rahnemai‐Azar¹,

Griesemer²,

Velasco³

et al. 2017

Oncology Letters

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Abstract. Ganglioneuromas are slow growing, clinically silent benign tumors for which surgery is considered to be the standard treatment. However, surgical excision in cases where surrounding structures are involved can be challenging. The present study reports a novel technique of ex vivo excision for the management of a retroperitoneal ganglioneuroma in a 21-year old patient, that appeared to be inoperable using standard surgical resection. Preoperative investigations revealed a large tumor with encasement of the origins of the superior mesenteric artery (SMA) and bilateral renal arteries. Initially, to prevent the need to explant the liver, the distal SMA (with takeoff of the replaced common hepatic artery) was anastomosed to the splenic artery. The bulk of the tumor along with the bilateral kidneys was mobilized from the retroperitoneum, and the aorta and inferior vena cava (IVC) were cross-clamped above and below the tumor and divided. The two kidneys were dissected free of the tumor at the back-table and were auto-transplanted in a standard technique following the reconstruction of the aorta and IVC. The patient tolerated surgery well and a one-year postoperative follow-up did not show any sign of tumor recurrence. Although technically demanding, ex vivo resection and auto-transplantation of the involved organs can be introduced as a final option for the treatment of tumors that are un-resectable using standard surgical techniques. IntroductionGanglioneuromas (GNs) are rare, slow-growing benign tumors arising from the sympatho-adrenal neuroendocrine system (1,2). GNs typically occur in children and adolescents, with up to 60% of patients <20 years old at the time of diagnosis. Additionally, females are more likely to be affected than males (3). GNs are the benign ends of a wide spectrum of peripheral neuroblastic tumors, which also include neuroblastoma, ganglioneuroblastoma and ganglioneuroblastoma intermixed (2,4). GN can be diagnosed de novo in healthy patients or in specific cases result from spontaneous or chemo-or radiotherapy induced maturation of less-differentiated neuroblastic tumors (neuroblastoma and ganglioneuroblastoma) (1,5). In addition, certain studies have presented an association between GNs and specific familial diseases including neurofibromatosis type 2 and multiple endocrine neoplasia type 2 (6,7). While GNs can occur anywhere along the sympathetic nervous system, the two most common locations of occurrence are the posterior mediastinum and retroperitoneum (6). Retroperitoneal tumors may originate from the adrenal glands or extra-adrenal tissues (6). There are a limited number of studies reporting tumor occurrence in uncommon locations, including the tongue, bladder, uterus and skin (8-10).Although complete surgical excision is considered to be the treatment of choice in the management of these tumors, occasionally it can be challenging and in specific cases (such as when large tumors are involving the surrounding vital organs) it is not a feasible option. The current case report pre...

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“…Thus, these procedures have rarely been performed. 1,2) Since most of the tumors invading into the IVC are at advanced stages, the prognosis is poor even after a successful operation. In addition, there are not many decision branches of effective treatment for tumors invading into the IVC.…”

Section: Discussionmentioning

confidence: 99%

Surgical Resection and Inferior Vena Cava Reconstruction for Treatment of the Malignant Tumor: Technical Success and Outcomes

Gotō

Hashimoto

Akamatsu

et al. 2014

Annals of Vascular Diseases

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Inferior vena cava resection and reconstruction for retroperitoneal tumor excision

Cited by 111 publications

References 14 publications

Sarcoma Resection With and Without Vascular Reconstruction: A Matched Case-Control Study

Sarcoma Resection With and Without Vascular Reconstruction: A Matched Case-Control Study

Ex vivo excision of retroperitoneal soft tissue tumors: A case report

Surgical Resection and Inferior Vena Cava Reconstruction for Treatment of the Malignant Tumor: Technical Success and Outcomes

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