Resection of primary leiomyosarcoma of the inferior vena cava (IVC) with reconstruction: A case series and review of the literature

Wachtel, Heather; Jackson, Benjamin M.; Bartlett, Edmund K.; Karakousis, Giorgos C.; Roses, Robert E.; Bavaria, Joseph E.; Fraker, Douglas L.

doi:10.1002/jso.23798

Cited by 76 publications

(67 citation statements)

References 30 publications

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“…Inferior vena cava or external iliac vein ligation without reconstruction results in major edema and may increase the risk of renal insufficiency. Some authors share this opinion, 8,16,17 whereas others routinely perform inferior vena cava resection without reconstruction. 18 In case of massive tumor invasion of a major vein, a collateral circulation is usually developed at the time of resection, with little or no long-term sequelae of the resection without reconstruction.…”

Section: Discussionmentioning

confidence: 99%

Oncovascular compartmental resection for retroperitoneal soft tissue sarcoma with vascular involvement

Bertrand

Carrère

Delmond

et al. 2016

Journal of Vascular Surgery

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Section: Discussionmentioning

confidence: 99%

Oncovascular compartmental resection for retroperitoneal soft tissue sarcoma with vascular involvement

Bertrand

Carrère

Delmond

et al. 2016

Journal of Vascular Surgery

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“…We also performed a PubMed literature search of the past 10 years by entering the search terms ‘leiomyosarcoma’ and ‘inferior vena cava’ [3, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, …”

Section: Discussionmentioning

confidence: 99%

Primary Leiomyosarcoma in the Inferior Vena Cava Extended to the Right Atrium: A Case Report and Review of the Literature

Fujita¹,

Takahashi²,

Kanzaki³

et al. 2016

Case Rep Oncol

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A 38-year-old woman had developed an abdominal distention, lower extremity edema, and dyspnea. Imaging examination revealed a large mass in the right atrium which was connected to lesions within the inferior vena cava. Although complete resection of the mass was not possible, partial surgical tumor resection was performed to avoid pulmonary embolization and circulatory collapse. Leiomyosarcoma was diagnosed histologically, and chemotherapy (doxorubicin) followed by radiotherapy was started. By reviewing papers published in the past 10 years that included 322 patients, we also discuss the clinical presentations and prognosis of leiomyosarcoma in the inferior vena cava.

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“…25 Bovine patch venotomy repair has also been used with acceptable patency rates. 7, 28-30 As with PTFE interposition grafts, there is an increased risk of infection with bovine patch repair compared to autologous or primary repair. Outcomes of IVC direct primary repair have been described in several studies, 8, 31-33 yet few studies have reported on long-term IVC patency associated with this technique.…”

Section: Discussionmentioning

confidence: 99%

The enduring patency of primary inferior vena cava repair

Mansukhani

Havelka

Helenowski

et al. 2017

Surgery

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Objective Inferior vena cava (IVC) repair after planned and unplanned venotomy is performed by either interposition bypass, patch venopasty, or lateral venorrhaphy and primary repair. Primary repair of the IVC avoids the use of foreign material and allows an all-autologous repair in an expeditious fashion. The purpose of this study was to demonstrate the utility of IVC repair, determine the degree of IVC stenosis and examine clinical outcomes after primary repair. Methods Single-center retrospective review of patients who underwent primary IVC repairs between January 2002 and January 2014 at a tertiary care center. Primary repair followed lateral venorrhaphy for tumor extraction or for repair of an iatrogenic IVC injury. Patient demographics, cross-sectional vena cava dimensions, and patient outcomes were tabulated. Results In total, 47 (30 men and 17 women) patients underwent primary IVC repair (median age 58 years, range 31-83 years). Twenty-six patients (15 men and 11 women) underwent en bloc radical nephrectomy, IVC tumor thrombus extraction, and primary lateral venorrhaphy (median age 61 years, range 39-83 years). The majority, 92% of these patients, had renal cell carcinoma (RCC) on final pathology, with a median follow-up period of 39 months (range 1-108 months). Twenty-one patients (15 men and 6 women) underwent primary repair for iatrogenic IVC injury (median age 54 years, range 31-82 years). Median follow-up period was 18.5 months (3-110 months). Clinic follow up with postoperative imaging was obtained in 76.9% of those undergoing tumor thrombus extraction (n=20) and 76.2% of those undergoing repair of an iatrogenic injury (n=16). Overall there was a 13% infra-renal IVC diameter loss, 17% IVC diameter loss at the level of the renal veins, and 10% supra-renal IVC diameter loss when comparing postoperative with preoperative imaging. All patients remained asymptomatic; therefore, IVC narrowing associated with primary repair was clinically insignificant. Conclusion Primary IVC repair is associated with less than 20% IVC diameter loss, and does not compromise venous outflow from the extremities. Primary IVC repair is a safe and expeditious technique that provides excellent clinical outcomes and long-term patency.

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Resection of primary leiomyosarcoma of the inferior vena cava (IVC) with reconstruction: A case series and review of the literature

Abstract: Leiomyosarcomas of the IVC present a technical challenge to the surgeon. Careful preoperative workup and a collaborative team consisting of experienced cardiac and vascular surgeons and surgical oncologists can allow for a safe and successful operation despite extensive tumor involvement.

Cited by 76 publications

References 30 publications

Oncovascular compartmental resection for retroperitoneal soft tissue sarcoma with vascular involvement

Oncovascular compartmental resection for retroperitoneal soft tissue sarcoma with vascular involvement

Primary Leiomyosarcoma in the Inferior Vena Cava Extended to the Right Atrium: A Case Report and Review of the Literature

The enduring patency of primary inferior vena cava repair

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