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

  • Innovative Surgical Techniques Around the World
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Abstract

Objective

Assessment of a simple layer peritoneal tube used as an autogenous inferior vena cava replacement.

Background

Extensive en-bloc multivisceral resection including major vessels is effective in selected abdominal malignancies, but the need for vascular reconstruction represents a surgical challenge. We describe the use of autologous peritoneum for caval replacement.

Methods

Autogenous parietal peritoneum without fascial backing was harvested and tubularized to replace the inferior vena cava (IVC) in four patients with complex abdominal tumors. Surgical morbidity was evaluated using the Clavien–Dindo classification, and graft patency was systematically evaluated with ultrasound.

Results

All four patients had multiorgan resections for malignancies involving the retro-hepatic IVC, and they all required the replacement of infrarenal and suprarenal IVC segments. Additionally, all four required a right nephrectomy, two had a combined major hepatectomy, and one patient needed a veno-venous bypass. All had an R0 resection. A clinical follow-up took place between 5 and 11 months after surgery for each patient. Four-month graft patency was confirmed by ultra-sound and TDM with no sign of disease recurrence.

Conclusions

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.

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References

  1. Schwarzbach MH, Hormann Y, Hinz U, Leowardi C, Bockler D, Mechtersheimer G et al (2006) Clinical results of surgery for retroperitoneal sarcoma with major blood vessel involvement. J Vasc Surg 44(1):46–55

    Article  PubMed  Google Scholar 

  2. Quinones-Baldrich W, Alktaifi A, Eilber F, Eilber F (2012) Inferior vena cava resection and reconstruction for retroperitoneal tumor excision. J Vasc Surg 55(5):1386–1393 (discussion 93)

    Article  PubMed  Google Scholar 

  3. Yoshidome H, Takeuchi D, Ito H, Kimura F, Shimizu H, Ambiru S et al (2005) Should the inferior vena cava be reconstructed after resection for malignant tumors? Am J Surg 189(4):419–424

    Article  PubMed  Google Scholar 

  4. Hardwigsen J, Baque P, Crespy B, Moutardier V, Delpero JR, Le Treut YP (2001) Resection of the inferior vena cava for neoplasms with or without prosthetic replacement: a 14-patient series. Ann Surg 233(2):242–249

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Hicks CW, Glebova NO, Piazza KM, Orion K, Pierorazio PM, Lum YW et al (2016) Risk of venous thromboembolic events following inferior vena cava resection and reconstruction. J Vasc Surg 63(4):1004–1010

    Article  PubMed  Google Scholar 

  6. Fiore M, Locati P, Mussi C, Guarino A, Piva L, Santinami M et al (2008) Banked venous homograft replacement of the inferior vena cava for primary leiomyosarcoma. Eur J Surg Oncol 34(6):720–724

    Article  CAS  PubMed  Google Scholar 

  7. Lim JH, Sohn SH, Sung YW, Moon HJ, Choi JS, Oh SJ (2014) Banked vena caval homograft replacement of the inferior vena cava for primary leiomyocsarcoma. Korean J Thorac Cardiovasc Surg 47(5):473–477

    Article  PubMed  PubMed Central  Google Scholar 

  8. Guerrero MA, Cross CA, Lin PH, Keane TE, Lumsden AB (2007) Inferior vena cava reconstruction using fresh inferior vena cava allograft following caval resection for leiomyosarcoma: midterm results. J Vasc Surg 46(1):140–143

    Article  PubMed  Google Scholar 

  9. Mehaffey JH, Perry RJ, Pope NH, Upchurch GR Jr (2016) Inferior vena cava reconstruction with tubularized bovine pericardium. J Vasc Surg Cases 2(1):28–30

    Article  PubMed  PubMed Central  Google Scholar 

  10. Pulitano C, Crawford M, Ho P, Gallagher J, Joseph D, Stephen M et al (2013) Autogenous peritoneo-fascial graft: a versatile and inexpensive technique for repair of inferior vena cava. J Surg Oncol 107(8):871–872

    Article  PubMed  Google Scholar 

  11. Dokmak S, Aussilhou B, Sauvanet A, Nagarajan G, Farges O, Belghiti J (2015) Parietal peritoneum as an autologous substitute for venous reconstruction in hepatopancreatobiliary surgery. Ann Surg 262(2):366–371

    Article  PubMed  Google Scholar 

  12. Badellino F, Toma S (2008) Treatment of soft tissue sarcoma: a European approach. Surg Oncol Clin N Am 17(3):649–672

    Article  PubMed  Google Scholar 

  13. Dindo D, Demartines N, Clavien PA (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 240(2):205–213

    Article  PubMed  PubMed Central  Google Scholar 

  14. Mingoli A, Sapienza P, Cavallaro A, Di Marzo L, Burchi C, Giannarelli D et al (1997) The effect of extend of caval resection in the treatment of inferior vena cava leiomyosarcoma. Anticancer Res 17(5B):3877–3881

    CAS  PubMed  Google Scholar 

  15. Babu SC, Mianoni T, Shah PM, Goyal A, Choudhury M, Eshghi M et al (1998) Malignant renal tumor with extension to the inferior vena cava. Am J Surg 176(2):137–139

    Article  CAS  PubMed  Google Scholar 

  16. Goto H, Hashimoto M, Akamatsu D, Shimizu T, Miyama N, Tsuchida K et al (2014) Surgical resection and inferior vena cava reconstruction for treatment of the malignant tumor: technical success and outcomes. Ann Vasc Dis 7(2):120–126

    Article  PubMed  PubMed Central  Google Scholar 

  17. Illuminati G, Calio FG, D’Urso A, Giacobbi D, Papaspyropoulos V, Ceccanei G (2006) Prosthetic replacement of the infrahepatic inferior vena cava for leiomyosarcoma. Arch Surg 141(9):919–924 (discussion 24)

    Article  PubMed  Google Scholar 

  18. Mingoli A, Feldhaus RJ, Cavallaro A, Stipa S (1991) Leiomyosarcoma of the inferior vena cava: analysis and search of world literature on 141 patients and report of three new cases. J Vasc Surg 14(5):688–699

    Article  CAS  PubMed  Google Scholar 

  19. Bower TC, Nagorney DM, Cherry KJ Jr, Toomey BJ, Hallett JW, Panneton JM et al (2000) Replacement of the inferior vena cava for malignancy: an update. J Vasc Surg 31(2):270–281

    Article  CAS  PubMed  Google Scholar 

  20. Kieffer E, Alaoui M, Piette JC, Cacoub P, Chiche L (2006) Leiomyosarcoma of the inferior vena cava: experience in 22 cases. Ann Surg 244(2):289–295

    Article  PubMed  PubMed Central  Google Scholar 

  21. Kuehnl A, Schmidt M, Hornung HM, Graser A, Jauch KW, Kopp R (2007) Resection of malignant tumors invading the vena cava: perioperative complications and long-term follow-up. J Vasc Surg 46(3):533–540

    Article  PubMed  Google Scholar 

  22. Szczurek Z, Kubicki B (1970) Morphological study of the internal lining formed by a free peritoneal graft in prostheses of the main aorta in dogs. Patol Pol 21(3):351–356

    CAS  PubMed  Google Scholar 

  23. Akimaru K, Onda M, Tajiri T, Yoshida H, Mamada Y, Taniai N et al (2000) Reconstruction of the vena cava with the peritoneum. Am J Surg 179(4):289–293

    Article  CAS  PubMed  Google Scholar 

  24. Salimi F, Hodjati H, Monabbati A, Keshavarzian A (2009) Inferior vena cava reconstruction with a flap of parietal peritoneum: an animal study. Arch Iran Med 12(5):448–453

    PubMed  Google Scholar 

  25. Emmiler M, Kocogullari CU, Yilmaz S, Cekirdekci A (2008) Repair of the inferior vena cava with autogenous peritoneo-fascial patch graft following abdominal trauma: a case report. Vasc Endovasc Surg 42(3):272–275

    Article  Google Scholar 

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Authors and Affiliations

  1. Department of Abdominal Surgery and Transplantation, Cliniques Universitaires Saint-Luc, Université catholique de Louvain, 10 Avenue Hippocrate, 1200, Brussels, Belgium

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

Authors
  1. Laurent Coubeau
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  2. Juan-Manuel Rico Juri
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  3. Olga Ciccarelli
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  4. Nicolas Jabbour
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  5. Jan Lerut
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Correspondence to Laurent Coubeau.

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The authors of this manuscript have no conflict of interest to disclose.

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Coubeau, L., Rico Juri, JM., Ciccarelli, O. et al. The Use of Autologous Peritoneum for Complete Caval Replacement Following Resection of Major Intra-abdominal Malignancies. World J Surg 41, 1005–1011 (2017). https://doi.org/10.1007/s00268-016-3804-7

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  • DOI: https://doi.org/10.1007/s00268-016-3804-7

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