The Use of Autologous Peritoneum for Complete Caval Replacement Following Resection of Major Intra‐abdominal Malignancies

Coubeau, Laurent; Juri, Juan Manuel Rico; Ciccarelli, Olga; Jabbour, Nicolas; Lerut, Jan

doi:10.1007/s00268-016-3804-7

Cited by 17 publications

(14 citation statements)

References 29 publications

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“…The parietal peritoneum was harvested from the posterior aponeurosis of the rectus abdominal muscle, thereby allowing a particularly stiff graft for support of the vena cava flow to be obtained[11]. Use of the peritoneum as a vascular graft has been reported in animal models[12] and has been described as a safe and good option for circumferential replacement of the vena cava[11,13-16]. This technique is inexpensive, it is readily and rapidly available, it uses the same surgical incision, and it allows caval replacement in a septic area.…”

Section: Discussionmentioning

confidence: 99%

Caval replacement with parietal peritoneum tube graft for septic thrombophlebitis after hepatectomy: A case report

Maulat

Lapierre

Migueres

et al. 2019

WJH

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BACKGROUNDCaval vein thrombosis after hepatectomy is rare, although it increases mortality and morbidity. The evolution of this thrombosis into a septic thrombophlebitis responsible for persistent septicaemia after a hepatectomy has not been reported to date in the literature. We here report the management of a 54-year-old woman operated for a peripheral cholangiocarcinoma who developed a suppurated thrombophlebitis of the vena cava following a hepatectomy.CASE SUMMARYThis patient was operated by left lobectomy extended to segment V with bile duct resection and Roux-en-Y hepaticojejunostomy. After the surgery, she developed Streptococcus anginosus, Escherichia coli, and Enterococcus faecium bacteraemias, as well as Candida albicans fungemia. A computed tomography scan revealed a bilioma which was percutaneously drained. Despite adequate antibiotic therapy, the patient’s condition remained septic. A diagnosis of septic thrombophlebitis of the vena cava was made on post-operative day 25. The patient was then operated again for a surgical thrombectomy and complete caval reconstruction with a parietal peritoneum tube graft. Use of the peritoneum as a vascular graft is an inexpensive technique, it is readily and rapidly available, and it allows caval replacement in a septic area. Septic thrombophlebitis of the vena cava after hepatectomy has not been described previously and it warrants being added to the spectrum of potential complications of this procedure.CONCLUSIONSeptic thrombophlebitis of the vena cava was successfully treated with antibiotic and anticoagulation treatments, prompt surgical thrombectomy and caval reconstruction.

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Section: Discussionmentioning

confidence: 99%

Caval replacement with parietal peritoneum tube graft for septic thrombophlebitis after hepatectomy: A case report

Maulat

Lapierre

Migueres

et al. 2019

WJH

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“…A tumoros infiltráció nemcsak a vena cavát érintheti, hanem az ide befolyó egyéb vénákat is, melyek pótlása technikailag mindenképpen jelentősebb kihívás. De akár ez is megoldható, mint például tumoros infiltráció miatt a vena cava körkörös és a vena renalis reszekciója [13]. Ennél gyakoribb probléma, ha a vena hepatica beömlé- [14].…”

Section: Megbeszélésunclassified

A vena cava inferiort infiltráló májtumorok kapcsán végzett reszekciókról

et al. 2019

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Introduction: Despite all new promising agents of oncotherapy, it is still liver resection that gives potential curative solution for primary and secondary liver tumors. The size of tumorous liver section for resection means no question any more but major vessel infiltration of tumor proposes challenge in liver surgery. Patients and method: Retrospective analysis was carried out covering 33 patients who underwent liver resection in St. Janos Hospital Surgery Department between 1st May 2017 and 1st May 2019. Demographic, surgical, histological data and postoperative course were taken into consideration and comparison with two of our patients who needed vena cava excision simultaneously with liver resection. Results: Patients with liver resection only (LR) had a mean operation time of 91.7 minutes, while operation time for patients with cava resection (CR) was 250 minutes. The average amount of blood transfusion was 1.2 units (200 ml) in group LR and 5 units in group CR. Among LR patients, resection was rated R0 in 23 and R1 in 8 cases, R2 resection could be performed in 2 cases, in group CR in both cases R1 resection was registered. 5 patients with colorectal liver metastasis were operated after previous chemotherapy. Two patients underwent laparoscopic liver resection and two had synchronous colorectal and liver resection, one of these was treated via laparoscopic approach. Conclusion: Liver resections in case of large vessel (vena cava, hepatic vein) infiltrating by liver tumors are indicated the most challenging procedures of liver surgery. The relating literature refers to oncological liver resections with vena cava excision and reconstruction to be safe and applicable. Orv Hetil. 2019; 160(33): 1304–1310.

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“…Several techniques for IVC replacement have been reported that use various materials, such as synthetic materials (Dacron, polytetrafluoroethylene (PTFE) vascular graft), a banked vena cava homograft, tubularized bovine pericardium or a stapled peritoneal fascial graft . Advantage of homograft is to dispense with anti coagulation.…”

Section: Reconstructionmentioning

confidence: 99%

“…The risk for graft infection is higher if a concomitant gut resection is conducted. Different reconstructive techniques have been proposed to reduce this risk as follows: an autologous fascio‐peritoneal patch from the posterior fascia of the rectus abdominis or a banked venous homograft . Late morbidity of the vena cava reconstruction by a prosthesis results in graft thrombosis in 10% to 40% of cases, and the risk for pulmonary embolism persists despite lifelong anticoagulation.…”

Section: Morbiditymentioning

confidence: 99%

Major vascular resections in retroperitoneal sarcoma

Tzanis

Bouhadiba

Gaignard

et al. 2017

Journal of Surgical Oncology

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Retroperitoneal sarcomas (RPS) frequently involve major vessels, which either originate from them or secondarily encase or invade them. In this field, major vascular resections result in increased morbidity. However, survival does not seem to be affected by the need for vascular resection or by this higher morbidity. This paper aims to provide descriptions of the surgical strategy and outcomes for retroperitoneal sarcomas involving major vessels.

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The Use of Autologous Peritoneum for Complete Caval Replacement Following Resection of Major Intra‐abdominal Malignancies

Abstract: Autologous peritoneum without fascial backing is a good and safe option for circumferential replacement of IVC after extensive en-bloc tumor resection with IVC involvement.

Cited by 17 publications

References 29 publications

Caval replacement with parietal peritoneum tube graft for septic thrombophlebitis after hepatectomy: A case report

Caval replacement with parietal peritoneum tube graft for septic thrombophlebitis after hepatectomy: A case report

A vena cava inferiort infiltráló májtumorok kapcsán végzett reszekciókról

Major vascular resections in retroperitoneal sarcoma

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