Reconstruction Techniques For Retroperitoneal Sarcoma Resection Involving The Juxta-renal IVC
Ross G. McFall, Tam T. Huynh, M.D., Barry W. Feig, M.D..
The Univ. of Texas MD Anderson Cancer Center, Houston, TX, USA.
Vascular surgeons are infrequently asked to assist with reconstruction of the inferior vena cava (IVC) for patients requiring surgical resection of the rare retroperitoneal sarcomatous tumor that involves the juxta-renal IVC. There are 3 basic methods for reconstructing the juxta-renal IVC after tumor resection: primary closure, patch angioplasty and interposition tube graft replacement, primarily based on the size of the IVC wall defect. In this educational video, we present 5 case examples to demonstrate the techniques for juxta-renal IVC resection and reconstruction. We discuss preoperative CT imaging, operative techniques, and postoperative CT surveillance. This video can be a helpful guide for vascular surgeons when performing juxta-renal IVC resection and reconstruction for oncologic indications. In particular, we have found that the left kidney function is usually preserved when ligation/resection of the left renal vein confluence (to the IVC) is done without needing reconstruction of the left renal vein.
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