Haemodynamic assessment following inferior vena cava resection without replacement.
BACKGROUND
Treatment of bulky retroperitoneal malignancy may require en bloc resection of the infrarenal inferior vena cava. A number of reconstructive options are available to the surgeon but objective haemodynamic assessment of the peripheral venous system following resection without replacement is lacking. The aim of the present paper was thus to determine the symptomatic and haemodynamic effects of not reconstructing the resected infrarenal inferior vena cava.


METHODS
A retrospective descriptive study was carried out at Princess Alexandra Hospital in Queensland. Five patients underwent resection of the thrombosed infrarenal inferior vena cava as part of retroperitoneal lymph node dissection for testicular cancer (n = 3), radical nephrectomy for renal cell carcinoma (n = 1) and thrombosed inferior vena cava aneurysm (n = 1). Clinical effects were determined via the modified venous clinical severity score and venous disability score. Haemodynamic data were obtained postoperatively using venous duplex ultrasound and air plethysmography.


RESULTS
None of the present patients scored >2 (out of 30) on the modified venous clinical severity score or >1 (out of 3) on the venous disability score. Haemodynamic studies showed only minor abnormalities.


CONCLUSIONS
Not reconstructing the resected thrombosed infrarenal inferior vena cava results in minor signs and symptoms of peripheral venous hypertension and only minor abnormalities on haemodynamic assessment.
Department of Vascular Surgery, Princess Alexandra Hospital, Wolloongabba, Queensland, Australia. arek_p@ecn.net.au
A Peter
AP
Wysocki
Rebecca
R
Hetherington
David
D
Nicol
Harry H
HH
Gibbs
D000293:Adolescent; D000328:Adult; D000368:Aged; D001775:Blood Circulation / Q000502:physiology*; D005500:Follow-Up Studies; D006801:Humans; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy; D010991:Plethysmography; D012187:Retroperitoneal Space; D012189:Retrospective Studies; D017131:Thrombectomy; D014463:Ultrasonography; D014680:Veins / Q000000981:diagnostic imaging / Q000503:physiopathology*; D014682:Vena Cava, Inferior / Q000503:physiopathology* / Q000601:surgery*