Surgical resection and graft replacement for primary inferior vena cava leiomyosarcoma: A multicenter experience

Nooromid, Michael J.; Martino, R; Squizzato, Francesco; Benedetto, Filippo; Caridi, Giovanni De; Chou, Elizabeth L.; Conrad, Mark F.; Pantoja, Joe L.; Abularrage, Christopher J.; Sorber, Rebecca; García-Ortega, Dorian Yarih; Luna-Ortiz, Kuauhyama; Eichler, Charles M.; Zarkowsky, Devin S.; Chia, Matthew C.; Kalluri, Aravind; Cohnert, Tina; Szeberin, Zoltán; Grotemeyer, D.; Shalhub, Sherene; Fagg, Damen; Jackson, Mark; Charlton-Ouw, Kristofer M.; Gombert, Alexander; Jacobs, Michael J.; Boyd, April J.; Motaganahalli, Raghu L.; Uceda, Domingo E.; Woo, Karen; Eskandari, Mark K.

doi:10.1016/j.jvsv.2021.06.021

Cited by 9 publications

(8 citation statements)

References 26 publications

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“…5 Polytetrafluoroethylene (PTFE) grafts remain the most widely used material for IVC reconstruction in clinical practice, however, use of synthetic materials necessitates long term anti-coagulation and is associated with higher risk of graft infection limiting their use in clean-contaminated cases. 6,7 Accordingly, use of biological materials including BP or autogenous peritoneo-fascial (APF), has emerged as an important development, however, little is known about the safety or efficacy of re-operating on patients with prior BP grafts in situ. 1 To our knowledge, these are the first described cases of redo resection following IVC reconstruction with BP, and thus provides valuable insights into the feasibility of such procedures and the in-vivo histopathological changes of the BP grafts.…”

Section: Discussionmentioning

confidence: 99%

Revision Surgery is Possible in Patients With Previous Bovine Pericardium Inferior Vena Cava Reconstruction: A Case Series and Review of Literature

Risbey

Khoma

Shin

et al. 2023

Vasc Endovascular Surg

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There is a paucity of research investigating revision surgery for patients with previous inferior vena cava (IVC) reconstruction using bovine pericardium (BP). To the best of our knowledge, no reports of redo procedures have been published in the medical literature. We describe two cases of redo surgery in patients with previous IVC reconstructions using BP following disease recurrence. The first case underwent resection of the BP graft with a second IVC reconstruction using BP, the second case underwent resection of the BP graft without reconstruction due to extensive thromboses. Neither case experienced perioperative complication or morbidity following their redo procedure, and previous IVC reconstruction with BP did not present significant intraoperative technical challenges. One case showed evidence of endothelialisation of the excised BP graft, however, it was not possible to definitively conclude if endothelialisation was present in the second case. Overall, these cases demonstrate that previous IVC reconstruction using BP should not be considered an absolute contraindication for redo surgery in the context of disease recurrence.

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Section: Discussionmentioning

confidence: 99%

Revision Surgery is Possible in Patients With Previous Bovine Pericardium Inferior Vena Cava Reconstruction: A Case Series and Review of Literature

Risbey

Khoma

Shin

et al. 2023

Vasc Endovascular Surg

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“…(In all cases, there is an additional risk of lower extremity edema). The main treatment of IVC leiomyosarcoma is surgical; however, resection and reconstruction techniques vary and are dependent on several factors ( 10 ). Surgical techniques include excision of the IVC, explantation of the liver with resection of the cava, resection of the cava utilizing total vascular exclusion with hypothermia, and liver transplantation with or without reconstruction of the IVC ( 2 , 8 , 11 , 12 ).…”

Section: Discussionmentioning

confidence: 99%

Case report: Surgical resection of a retro-hepatic leiomyosarcoma involving atrial reconstruction, cardiopulmonary bypass, ex vivo tumor resection, and liver re-implantation

Sharma

Okakpu²,

Murthy³

et al. 2022

Front. Surg.

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IntroductionLeiomyosarcomas (LMS) involving the inferior vena cava (IVC) is a clinically rare entity, accounting for approximately 0.5% of all adult sarcomas.Case presentationA 67-year-old male presented to the emergency department with mild back and lower abdominal pain. During the workup, a computed tomography scan without contrast showed an area of decreased attenuation within the liver adjacent to the intrahepatic IVC. Magnetic resonance imaging confirmed the involvement of the retro-hepatic IVC; biopsy confirmed the diagnosis of LMS. Given the location of the involvement of the retro-hepatic IVC, liver explantation was deemed necessary for adequate tumor resection. The superior extension of the tumor toward the heart necessitated Cardio-Pulmonary (CPB). The patient successfully underwent a complex surgical procedure involving liver explantation with ex vivo back-table resection of the retro-hepatic LMS, replacement of the retro-hepatic vena cava with a ringed Gore-Tex graft, liver re-implantation, and hepatic vein-atrial reconstruction under cardiopulmonary bypass. There were no intraoperative or post-op complications.DiscussionThe role of vascular reconstruction of the IVC varies depending on the level and extent of the tumor, with options ranging from primary repair, ligation, or reconstruction dictated. Surgical resection with negative margins remains the treatment of choice due to the lack of efficacy of adjuvant therapies. Importantly, liver explantation offers a chance for complete surgical resection and reconstruction. Similarly, the complex nature of the tumor necessitated a pioneering approach involving direct hepato-atrial venous anastomosis.ConclusionTo the best of our knowledge, this is the first reported case in which the hepatic veins were anastomosed directly to the right atrium while also replacing the native vena cava with a separate graft.

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“…The necessity for the graft material to be used in the reconstruction of hepatic vein or inferior vena cava should be limited based on the underlying risk factors and the degree of postoperative complications. This involvement of hepatic vein and inferior vena cava allows the excellent access of reconstruction for implantation, thereby allowing the liver to function normally by rotating to the surface of the operative field (10,11). The applications of liver resection techniques and reconstructions of both inferior vena cava and hepatic vein promote the role of the liver in resection and is beneficial to some particular patients, thus requiring specialized centers with specialized medical personnel to administer (2).…”

Section: Methodsmentioning

confidence: 99%

Hepatic Vein and Inferior Vena Cava Reconstruction during Hepatic Surgery Resection for Cancer

Coco¹,

Leanza²

2021

jrenhep

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Invasion of tumor in the liver requires surgical interventions that may reduce the effects or may eliminate the tumor-affected cells. The renewal of the hepatic vein and inferior vena cava has enabled most specialized oncologists and medical specialists to use advanced diagnostic methods in the treatment of the liver tumors. Liver resection has prolonged the lives of many patients and the invention of live donor organ transplants has effectively enabled the use of liver resection in most cancer centers across the world. By reviewing data from 10 articles, 21 surgical analyses were investigated and analyzed for the risks involved in the applications of reconstructions of hepatic vein and inferior vena cava in the surgical liver resection. The postoperative complications and the indications of reconstructions were mentioned. The results indicated that with these surgical procedures, complications are still involved but may be successful for particular patients.

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Surgical resection and graft replacement for primary inferior vena cava leiomyosarcoma: A multicenter experience

Cited by 9 publications

References 26 publications

Revision Surgery is Possible in Patients With Previous Bovine Pericardium Inferior Vena Cava Reconstruction: A Case Series and Review of Literature

Revision Surgery is Possible in Patients With Previous Bovine Pericardium Inferior Vena Cava Reconstruction: A Case Series and Review of Literature

Case report: Surgical resection of a retro-hepatic leiomyosarcoma involving atrial reconstruction, cardiopulmonary bypass, ex vivo tumor resection, and liver re-implantation

Hepatic Vein and Inferior Vena Cava Reconstruction during Hepatic Surgery Resection for Cancer

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