A multidisciplinary approach for abdominal venous involvement in oncologic resections

Area of Science:

• Surgical Oncology
• Vascular Surgery
• Multidisciplinary Care

Background:

• Increasing use of aggressive surgical approaches for locally advanced malignancy without distant metastases.
• Resection and reconstruction of major venous structures are integral to these procedures.
• Investigation into the efficacy of a multidisciplinary surgical approach for such cases.

Purpose of the Study:

• To evaluate the outcomes of a multidisciplinary surgical approach in patients undergoing major venous resection and reconstruction for advanced malignancy.
• To analyze rates of margin positivity, postoperative venous patency, and survival.
• To assess secondary outcomes including operative time, blood loss, and hospital stay.

Main Methods:

• Retrospective analysis of 23 patients from a university-affiliated hospital (2006-2012).
• Inclusion of patients undergoing oncologic resection with vascular surgery consultation.
• Primary outcomes: margin positivity, venous patency, survival; Secondary outcomes: operative time, blood loss, hospital stay.

Main Results:

• Overall positive margin rate was 56.5%, with vascular margin positivity at 30.4%.
• Postoperative venous patency was 65.0%.
• Median survival was 10 months, with no perioperative mortalities.

Conclusions:

• Major venous resections and reconstructions in oncologic surgery are feasible and safe.
• High rates of positive margins highlight the need for improved preoperative assessment.
• Enhanced multidisciplinary planning, especially in the preoperative phase, is crucial for optimizing patient outcomes.