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Concomitant vascular procedures for malignancies with vascular invasion
Costanzo A DiPerna1, Michael E Bowdish, Fred A Weaver
1Department of Surgery, Division of Vascular Surgery, Keck School of Medicine, University of Southern California, 1510 San Pablo St, Suite 514, Los Angeles, CA 90033, USA.
Archives of Surgery (Chicago, Ill. : 1960)
|July 31, 2002
Summary
Vascular reconstruction techniques safely enable tumor resection involving major blood vessels, showing good outcomes. These procedures offer acceptable morbidity and mortality for patients requiring complex tumor removal.
Area of Science:
- Vascular Surgery
- Surgical Oncology
- Oncologic Reconstruction
Background:
- Tumors invading major vascular structures pose significant challenges in surgical oncology.
- Resection of these tumors often necessitates complex vascular reconstruction to achieve oncologic goals.
Purpose of the Study:
- To evaluate the safety and efficacy of contemporary reconstructive vascular techniques in patients undergoing tumor resection involving major vessels.
- To assess early and late morbidity, mortality, and oncologic outcomes following such procedures.
Main Methods:
- A retrospective review of a vascular surgery registry from 1987 to 2001.
- Analysis of 49 patients who underwent concomitant vascular resection and reconstruction for tumor removal.
- Outcomes assessed included early/late morbidity and mortality, vascular reconstruction patency, and tumor-free survival.
Main Results:
- Vascular reconstructions included aorta (41.7%), inferior vena cava (12.5%), iliac/femoral/popliteal vessels (31.3%), portal vein (16.7%), and brachiocephalic/superior vena cava (4 patients).
- Thirty-day mortality was 2.1%, with overall 30-day morbidity at 12.2%.
- Primary patency of vascular reconstructions was 90% at 24 months, with 70% tumor-free survival and 63% of patients alive without recurrence at 24 months.
Conclusions:
- Contemporary reconstructive vascular procedures are safe and effective for resecting tumors involving major vascular structures.
- These techniques allow for complete tumor removal with acceptable early and late morbidity and mortality.
- Successful vascular reconstruction is crucial for achieving favorable oncologic and survival outcomes.