Combined liver and inferior vena cava resection for hepatic malignancy.
OBJECTIVE
The experience from a single center, in combined liver and inferior vena cava (IVC) resection for liver tumors, is presented.


METHODS
Twelve patients underwent a combined liver resection with IVC replacement. The median age was 45 years (range 35-67 years). Resections were carried out for hepatocellular carcinoma (n = 4), colorectal metastases (n = 6), and cholangiocarcinoma (n = 2). Liver resections included eight right lobectomies and four left trisegmentectomies. The IVC was reconstructed with ringed Gore-Tex tube graft.


RESULTS
No perioperative deaths were reported. The median operative blood transfusion requirement was 2 units (range 0-12 units) and the median operative time was 5 hr. Median hospital stay was 10 days (range 8-25 days). Three patients had evidence of postoperative liver failure, resolved with supportive management. Two patients developed bile leaks, resolved conservatively. With a median follow up of 24 months, all vascular reconstructions were patent and no evidence of graft infection was documented.


CONCLUSIONS
Aggressive surgical management of liver tumors, offer the only hope for cure or palliation. We suggest that liver resection with vena cava replacement may be performed safely, with acceptable morbidity, by specialized surgical teams.
Delis
Spiros G
SG
Department of Surgery, Division of Transplantation, University of Miami School of Medicine, Miami, Florida 33101, USA. sgdelis55@yahoo.gr
Madariaga
Juan
J
Ciancio
Gaetano
G
D000328:Adult; D000368:Aged; D001803:Blood Transfusion / Q000706:statistics & numerical data; D019917:Blood Vessel Prosthesis Implantation; D006528:Carcinoma, Hepatocellular / Q000601:surgery; D018281:Cholangiocarcinoma / Q000601:surgery; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008099:Liver / Q000601:surgery*; D008113:Liver Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011138:Polytetrafluoroethylene; D016896:Treatment Outcome; D014682:Vena Cava, Inferior / Q000601:surgery*
D011138:Polytetrafluoroethylene