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Related Experiment Videos

Cardiovascular interventions during oncologic surgery: technical principles and mid-term survival.

T Carrel1, P Berdat, J Schmidli

  • 1Clinic for Cardiovascular Surgery, University Hospital Berne, Switzerland. thierry.carrel@insel.ch

VASA. Zeitschrift Fur Gefasskrankheiten
|July 20, 2000
PubMed
Summary

Vascular reconstruction during cancer surgery can be safely performed, offering a 45% mid-term survival rate in patients with malignant tumors involving major arteries and veins. This aggressive surgical approach is justified for selected patients.

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Area of Science:

  • Vascular Surgery
  • Surgical Oncology
  • Oncologic Imaging

Background:

  • Arterial stenosis from tumors is less common than venous compression due to higher internal pressure.
  • Tumor infiltration of the arterial adventitia necessitates careful surgical consideration.
  • Radical tumor resection can risk injury to infiltrated arterial structures.

Purpose of the Study:

  • To report technical principles for vascular reconstruction during malignant tumor surgery.
  • To evaluate mid-term survival rates in patients undergoing such procedures.
  • To assess the feasibility of aggressive surgical intervention in selected cancer patients.

Main Methods:

  • Retrospective analysis of 35 patients undergoing vascular reconstruction for malignant tumors.

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  • Involved vessels included carotid artery, superior vena cava, aortic arch, subclavian artery, right atrium, inferior vena cava, abdominal aorta, and iliac vessels.
  • Surgical techniques comprised extra-anatomic bypass, in situ reconstruction with grafts or vein interposition, patch angioplasty, and vessel ligation. Cardiopulmonary bypass was used for intracardiac tumor excision in 5 patients.

    • Main Results:

    • No intraoperative mortality was observed.
    • Two patients died before hospital discharge (pneumonia, sepsis).
    • Mid-term survival was 45% at a mean follow-up of 4.5 years across all tumor types.

    Conclusions:

    • Aggressive surgical management involving vascular reconstruction is feasible and can be justified in appropriate patients.
    • This approach may expand operative candidacy for patients with malignant tumors involving major vasculature.
    • Satisfactory mid-term survival rates support the consideration of such aggressive strategies.