Vascular reconstruction in limbs associated with resection of tumors.
Patients with tumors in limbs who undergo surgical treatment may present involvement of major vessels. The artery must be reconstructed for limb salvage and the vein may be reconstructed to avoid the onset of venous hypertension. The objective of this study was to analyze the results from surgical treatment of tumors associated with vascular reconstruction in limbs. A prospective follow-up was made of 17 patients with tumors involving major vessels in limbs who underwent vascular reconstruction. Arterial and venous reconstructions were performed in nine patients, arterial reconstruction was performed in six, and venous reconstruction in two patients. The vascular substitutes used were greater saphenous vein (19), expanded polytetrafluoroethylene prosthesis (5), and Dacron prosthesis (2). Vascular complications occurred in seven patients: one arterial graft rupture, three venous graft occlusions, and lymphedema in five patients. The following nonvascular complications occurred in 10 patients: pulmonary metastasis (7), local recurrence (2), neurological deficit (2), infection (2), partial necrosis of the flap (1), and enteric fistula (1). Six patients with pulmonary metastasis died. One patient underwent transfemoral amputation. Major vessel reconstruction in limbs associated with resection of neoplasms is a safe procedure. Venous revascularization should be performed using an autologous substitute.
Nishinari
Kenji
K
Department of Vascular Surgery, Hospital do Câncer A.C. Camargo, São Paulo, Brazil. marken@uol.com.br
Wolosker
Nelson
N
Yazbek
Guilherme
G
Malavolta
Luiz Caetano
LC
Zerati
Antônio Eduardo
AE
Penna
Valter
V
Lopes
Ademar
A
D000328:Adult; D001807:Blood Vessel Prosthesis; D001859:Bone Neoplasms / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007866:Leg / Q000098:blood supply*; D008297:Male; D011446:Prospective Studies; D019651:Plastic Surgery Procedures; D012501:Saphenous Vein / Q000637:transplantation; D012983:Soft Tissue Neoplasms / Q000601:surgery*; D013997:Time Factors; D014656:Vascular Surgical Procedures