Liver resection combined with inferior vena cava resection and reconstruction using artificial vascular graft: A literature review

Abstract

In cases where liver tumors invade the inferior vena cava (IVC), IVC resection along with liver resection may be needed to effect a cure. Furthermore, if the IVC defect is large, IVC reconstruction with vascular graft after resection is required. There are limited reports of cases of IVC reconstruction using a graft. By reviewing data from the literature of previous studies, the present study was aimed at investigating the surgical outcomes of liver resection with IVC resection and reconstruction using an artificial vascular graft. PubMed was searched for previous articles reporting cases with the combined surgery. The search was limited to articles in English, and cases with exceptional surgeries such as in situ cold perfusion, and ante situm and ex vivo techniques were excluded from this study. Surgical outcomes of the extracted cases were investigated. Cases dealt only with primary closure after IVC resection, and those in which the IVC tumor thrombus was treated by opening the IVC wall, removing the thrombus and then closing the IVC without wall excision were not included in this study. The literature search identified 13 studies, including 111 cases. Operative mortality in the reported cases was 8.1% (9 out of 111 cases). Thrombus in the artificial vascular graft was observed in two cases, and patency of the graft during the follow‐up period was confirmed in 109 of the 111 cases (98.2%). These results suggested that the surgical outcomes of liver resection combined with IVC resection and reconstruction using the artificial vascular graft were favorable.

Liver resection and transplantation for intrahepatic cholangiocarcinoma

“…23,24 In a recent multiinstitutional analysis of 128 patients who underwent major vascular resections of the inferior vena cava and portal vein (21 and 98 patients, respectively), the perioperative outcomes were comparable to those achieved in 959 cases of conventional resection, suggesting that major vascular resections and reconstructions can be considered in properly selected patients, if R0 margin can be achieved. 25,26 Concerning the recommended future liver remnant (FLR) volume, iCCA does not differ from other indications for LR, with a threshold of 25% of liver volume to be preserved for patients with normal parenchyma. Conversely, patients with iCCA in the context of chronic liver disease will require a minimum FLR of 40% with no portal hypertension.…”

Hepatic Vein and Inferior Vena Cava Reconstruction during Hepatic Surgery Resection for Cancer

“…The patients with liver cancer who underwent hepatic resection were as follows: the number of testicular tumor was four, leiomyosarcomas were two, metastatic liver tumor of the colon were two, hepatoblastoma were two, cholangiocarcinoma was one, and the other 10 had other types of cancer. Eleven of the total number presented prevailing conditions of liver cirrhosis while the rest were presented without liver cirrhosis (1,(3)(4)(5). Surgical procedures were examined based on cancer grade and liver function in the research studies.…”

The Recent Development of the Surgical Treatment for Hepatocellular Carcinoma

“…In addition, in cases with IVCTT invades the vascular wall, IVC resection and reconstruction along with liver resection has been reported to be safely performed by using an artificial graft. Therefore, surgery should be performed without hesitation [48,49]. The significance of liver resection for the patients with IVCTT should be considered from the perspective of oncology and the prevention of sudden death.…”