Oncovascular Surgery and the Making of the Oncovascular Surgeon

Abstract

Patients diagnosed with tumors that are located in vicinity of the major axial vessels are inconsistently managed because they are often considered unresectable. The management of these patients remains at the periphery of various established sub-specialties that are prevalent under the current medical specialty. These patients are required to be treated by an oncovascular surgeon. This article discusses some key points in understanding the reasons for establishing a specialty branch, oncovascular surgery, to treat complex tumors with vessel invasion. This article also reviews important issues about leadership and how to train and educate oncovascular surgeons.

Patient Transfer with Kocher Forceps on the Axillary Artery: A Rare Case of Ongoing Iatrogenic Vascular Injury

“…Regarding the operative strategy during definitive management of this type of injury, a stepwise approach is mandatory that adheres to the principles of proximal and distal vascular control prior to the attempt of any risky dissection of the previously dissected area. The concept of oncovascular surgery has recently become widely used and emphasized during the resection of benign or malignant tumors with anticipated involvement/critical proximity of the tumor to major vascular structures [ 8 - 10 ]. The use of an oncovascular multidisciplinary team approach is important.…”

“…Vascular surgeons play a crucial role in achieving better outcomes; thus, they must take initiative from preoperative planning and surgery to postoperative treatment. Undoubtedly, this implies the need for dedicated and accredited senior oncovascular fellowships in specialized high-volume centers [ 8 - 10 ]. To the best of our knowledge, despite the recognition of this training gap on an international scale, no relevant accredited pathway has yet been established.…”

A Multidisciplinary Approach to Oncological Resections with Vascular Surgeons Improves Patient Outcomes

“…The phrase 'oncovascular surgery' has been used to describe this collaborative work. 2,12,13 This study presents a case series of 72 patients who underwent tumour surgery at a public hospital network in Adelaide, Australia. These cases involved collaboration between vascular surgery and other surgical disciplines and are among the most complex oncological resections undertaken.…”

“…As oncovascular surgery progresses, more specialist oncovascular centres are likely to develop, where patients will benefit from treatment by surgeons who commonly perform these very complex procedures. 12,13…”

Oncovascular Resection and Reconstruction of Recurrent Retroperitoneal Liposarcoma Adherent to the Iliac Veins and Vena Cava

“…In the absence of systemic disease, resection is the treatment of choice which often results in prolonged disease control, when the approach is optimized. Vascular involvement may necessitate vessel resection and planned reconstruction, as part of the curative resection [ 1 ]. Vascular surgeons are increasingly involved in oncologic surgeries, and according to the concept of oncovascular surgery, tumor excision with concomitant resection of the involved vessels may be curative and margin-free [ 2 ].…”