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16.03.2021 | Original Scientific Report

Single-Centre Experience of Supra-Renal Vena Cava Resection and Reconstruction

verfasst von: Nikola Vladov, Radoslav Kostadinov, Vassil Mihaylov, Ivelin Takorov, Tsonka Lukanova, Maria Yakova, Tsvetan Trichkov, Evelina Odisseeva, Ventsislav Mutafchiyski

Erschienen in: World Journal of Surgery | Ausgabe 7/2021

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Abstract

Background

Tumours involving the supra-renal segment of IVC have dismal prognosis if left untreated. Currently, aggressive surgical management is the only potentially curative treatment but is associated with relatively high morbidity and mortality. This study aims to evaluate perioperative factors, associated with adverse postoperative outcomes, based on the perioperative characteristics and type of IVC reconstruction.

Methods

We identified 44 consecutive patients, who underwent supra-renal IVC resection with a mean age of 57.3 years. Isolated resection of IVC was performed in four patients, concomitant liver resection was performed in 27 patients and other associated resection in 13 patients. Total vascular exclusion was applied in 21 patients, isolated IVC occlusion in 11 patients. Neither venovenous bypass (VVB) nor hypothermic perfusion was used in any of the cases.

Results

The mean operative time was 205 min (150–324 min) and the mean estimated blood loss was 755 ml (230–4500 ml). Overall morbidity was 59% and major complications (Dindo-Clavien ≥ III) occurred in 11 patients (25%). The 90-day mortality was 11% (5pts). Intraoperative haemotransfusion was significantly associated with postoperative general complications (p < 0,001). With a mean follow-up of 26.2 months, the actuarial 1-, 3- and 5-year survival is 69%, 34%, and 16%, respectively.

Conclusions

IVC resection and reconstruction in the aspect of aggressive surgical management of malignant disease confers a survival advantage in patients, often considered unresectable. When performed in experienced centres it is associated with acceptable morbidity and mortality.

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Titel: Single-Centre Experience of Supra-Renal Vena Cava Resection and Reconstruction
verfasst von: Nikola Vladov
Radoslav Kostadinov
Vassil Mihaylov
Ivelin Takorov
Tsonka Lukanova
Maria Yakova
Tsvetan Trichkov
Evelina Odisseeva
Ventsislav Mutafchiyski
Publikationsdatum: 16.03.2021
Verlag: Springer International Publishing
Erschienen in: World Journal of Surgery / Ausgabe 7/2021
Print ISSN: 0364-2313
Elektronische ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-021-06048-w

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Single-Centre Experience of Supra-Renal Vena Cava Resection and Reconstruction