Abstract
Purpose: The involvement of the inferior vena cava (IVC) in advanced abdominal tumors is a surgical challenge, given the high postoperative morbidity and poor long-term prognosis. IVC reconstruction is not always required due to the formation of collateral veins. Our goal was to analyze our experience, perioperative management, and results. Methods: We retrospectively evaluated short and long-term results of surgical resections of tumors with associated inferior vena cava resection performed in our facilities between 2012 and 2020. Results: 15 patients were selected for our retrospective study: 1 with renal carcinoma, 4 with sarcoma, 7 with colorectal metastases, 2 with adrenal tumors, and 1 with hepatocellular carcinoma. 7 were male with an average age of 59.06 years. The postoperative severe complications (Dindo-Clavien ≥ IIIa) affected 40% of patients and the mortality rate was 13.3%. Partial resection with primary repair was performed in 7 patients (46.7%), with patch reconstruction in 1 (6.7%), thrombectomy in 2 (13.3%), and vascular reconstruction with prosthesis in 5 patients (33.3%). The average follow-up was 30.62 months. The 1, 3 and 5-year OS rates were 100%, 91% and 43%, respectively; excluding the postoperative mortality. The mean DFS was 11.53 months. The 1, 3 and 5-year DFS rates were 46%, 18% and 18%, respectively. Graft thrombosis occurred in 3 patients (20%) during follow-up. Six patients were prescribed follow-up anticoagulation. Conclusion: IVC resection, though a technically demanding procedure, can be safely performed to achieve complete tumor resection with relative survival improvement and acceptable mortality and morbidity rates in selected patients.
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