Resection of Primary Leiomyosarcoma of the Inferior Vena Cava (IVC) With Reconstruction: A Case Series and Review of the Literature
Resection of Primary Leiomyosarcoma of the Inferior Vena Cava (IVC) With Reconstruction: A Case Series and Review of the Literature
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DOI：
10.1002/jso.23798
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发表时间：
2015-03-01
影响因子：
2.5
通讯作者：
Fraker, Douglas L.
中科院分区：
文献类型：
--
作者：
Wachtel, Heather;Jackson, Benjamin M.;Fraker, Douglas L.
背景下腔静脉平滑肌肉瘤是一种罕见的肿瘤，对外科治疗提出了独特的挑战。我们提出了一系列的6例平滑肌肉瘤切除与IVC reconstruction.MethodsRetrospective图表审查进行了初步手术切除原发性平滑肌肉瘤与IVC reconstruction的患者，在三级护理center.ResultsBetween 2005-2013，6例患者进行了切除与重建。一半是女性，平均年龄为5715.4岁。3例患者需要整块切除邻近器官。3例患者在静脉-静脉转流中切除，1例在体外循环中切除。3例接受IVC补片修复（牛心包，n=2;隐静脉，n=1），3例接受IVC移植物重建（涤纶，n=1; PTFE，n=1;同种主动脉，n=1）。所有这些公司的利润率都为负数。中位无病生存期为34个月（IQR 7-52个月），中位疾病特异性生存期为51个月（IQR 20-108）。五年无病生存率和疾病特异性生存率分别为30%和66.7%，respectively. ConclusionsLeiomyelomyelomas的下腔静脉提出了一个技术挑战的外科医生。仔细的术前检查和由经验丰富的心脏和血管外科医生和外科肿瘤学家组成的协作团队可以确保安全和成功的手术，尽管广泛的肿瘤参与。外科肿瘤学杂志2015 111：328-333. (c)2014年威利期刊公司
BackgroundLeiomyosarcoma of the inferior vena cava (IVC) is a rare tumor which presents a unique surgical challenge. We present a series of six cases of leiomyosarcoma resection performed with IVC reconstruction.MethodsRetrospective chart review was performed for patients undergoing initial operative resection of primary leiomyosarcoma with IVC reconstruction, at a tertiary care center.ResultsBetween 2005-2013, six patients underwent resection with reconstruction. Half were female, and the mean age at presentation was 5715.4 years. Three patients required en bloc resection with adjacent organs. Three patients were resected on venovenous bypass, and one on cardiopulmonary bypass. Three underwent IVC patch repair (bovine pericardium, n=2; saphenous vein, n=1), and three had IVC reconstruction with graft (Dacron, n=1; PTFE, n=1; aortic homograft, n=1). All achieved grossly negative margins. Median disease-free survival was 34 months (IQR 7-52 months), and median disease-specific survival was 51 months (IQR 20-108). Five year disease-free and disease-specific survival rates were 30% and 66.7%, respectively.ConclusionsLeiomyosarcomas of the IVC present a technical challenge to the surgeon. Careful preoperative workup and a collaborative team consisting of experienced cardiac and vascular surgeons and surgical oncologists can allow for a safe and successful operation despite extensive tumor involvement. J. Surg. Oncol. 2015 111:328-333. (c) 2014 Wiley Periodicals, Inc.