title: Vena caval reconstruction during postchemotherapy retroperitoneal lymph node dissection for metastatic germ cell tumor.
abstract: We present our experience with inferior vena cava (IVC) reconstruction in patients undergoing post-chemotherapy retroperitoneal lymph node dissection (PC-RPLND) due to metastatic germ cell tumor. Four patients underwent IVC reconstruction with a prosthetic graft. Early postoperative leg edema was prevented in all 4. Long-term graft patency was maintained in 3 patients, who remained free of chronic venous disorders for a median follow-up of 19 months (range of 13-55 months). In a fourth patient, graft occlusion was noted during follow up, caused by compression of the graft by a recurrent tumor. We conclude that when resection of the IVC is indicated during PC-RPLND, replacement by a prosthetic graft may prevent immediate postoperative leg edema and later chronic venous insufficiency.
authors.affiliation: Department of Urology, Rabin Medical Center, Petah Tiqwa, Israel. ehrlichy@netvision.net.il
authors.forename: Yaron
authors.initials: Y
authors.lastname: Ehrlich
authors.forename: Daniel
authors.initials: D
authors.lastname: Kedar
authors.forename: Avigdor
authors.initials: A
authors.lastname: Zelikovski
authors.forename: Miriam
authors.initials: M
authors.lastname: Konichezky
authors.forename: Jack
authors.initials: J
authors.lastname: Baniel
mesh_terms: D000328:Adult; D003131:Combined Modality Therapy; D006801:Humans; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D009373:Neoplasms, Germ Cell and Embryonal / Q000188:drug therapy* / Q000556:secondary / Q000601:surgery*; D013736:Testicular Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery*; D014682:Vena Cava, Inferior / Q000601:surgery*; D055815:Young Adult