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Clinical outcomes after inferior vena cava resection for malignant disease. A single center experience of 51 vena cava resections.
- Source :
-
European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology [Eur J Surg Oncol] 2024 Jun; Vol. 50 (6), pp. 108253. Date of Electronic Publication: 2024 Mar 07. - Publication Year :
- 2024
-
Abstract
- Background and Objective: For tumors involving inferior vena cava (IVC), surgery with complete resection remains the first line treatment. Management of IVC after resection, either ligation without reconstruction or primary reconstruction, is debated. Our study aimed to evaluate type of venous reconstruction, anticoagulation management and morbidity.<br />Methods: A French single center database of patients who underwent partial or total circumferencial resection of the IVC for malignant disease was analyzed. Inclusion criteria were any oncologic procedure for a retroperitoneal neoplasm requiring concomitant resection of the IVC with or without venous reconstruction with prosthesis. Exclusion criteria were surgery before year 2000. Data were descriptive and reverse Kaplan Meier was used for follow-up calculation. The endpoints were the rate of prosthetic reconstruction, the use of anticoagulation and the post-operative outcomes.<br />Results: Fifty - one patients were included with a median duration of follow-up of 54.8 months. The majority of patients were men (56.9%). Median age of the population was 44.1 years. Most of the patients underwent surgery for primary testicular cancer and for sarcoma. Complete IVC resections were performed in 46 (90,2%) patients, 32 having a concomitant prosthetic replacement. Eight patients underwent aortic resection in the same operative time. Postoperative morbidity was 33.3%. Post-operative anticoagulation was done in 24 patients. At 1 month, four patients developed thrombosis in the prosthesis.<br />Conclusions: IVC resections are feasible and safe. Venous reconstruction and postoperative management were planned according to the preoperative imaging and intraoperative findings. We propose a decision-tree for peri-operative management and anticoagulation.<br /> (© 2024 Elsevier Ltd, BASO ∼ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.)
- Subjects :
- Humans
Male
Female
Adult
Middle Aged
Treatment Outcome
Aged
Anticoagulants therapeutic use
Retrospective Studies
Testicular Neoplasms surgery
Testicular Neoplasms pathology
Retroperitoneal Neoplasms surgery
Retroperitoneal Neoplasms pathology
Sarcoma surgery
Sarcoma pathology
Vascular Neoplasms surgery
Vascular Neoplasms pathology
Young Adult
Vena Cava, Inferior surgery
Vena Cava, Inferior pathology
Subjects
Details
- Language :
- English
- ISSN :
- 1532-2157
- Volume :
- 50
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology
- Publication Type :
- Academic Journal
- Accession number :
- 38552418
- Full Text :
- https://doi.org/10.1016/j.ejso.2024.108253