Reconstruction Techniques For Retroperitoneal Sarcoma Resection Involving The Juxta-Renal IVC
Tam T Huynh
University of Texas MDAnderson Cancer Center, Houston, TX
OBJECTIVES:Vascular surgeons are infrequently asked to assist with reconstruction of the inferior vena cava (IVC) for patients requiring surgical resection of rare retroperitoneal sarcomatous tumor that involves the juxta-renal IVC. In this educational video, we present 5 case examples to demonstrate the various techniques for juxta-renal IVC resection and reconstruction.
METHODS: We show preoperative CT imaging, operative techniques, and postoperative CT surveillance.
RESULTS: There are 3 basic methods for reconstructing the juxta-renal IVC wall defect after tumor resection: primary closure, patch angioplasty and interposition tube graft replacement. Surgeons can select which method to use based on the size of the IVC wall defect. Furthermore, we have found that the left kidney (and function) can usually preserved even when the left left renal vein to IVC confluence is resected (without reconstruction of the left renal vein, provided that collateral flow is preserved via the left gonadal, lumbar, and adrenal veins).
CONCLUSIONS: This video can be a helpful guide for vascular surgeons when performing juxta-renal IVC resection and reconstruction for oncologic indications.
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