The Experts below are selected from a list of 315 Experts worldwide ranked by ideXlab platform
Fritz C Eilber - One of the best experts on this subject based on the ideXlab platform.
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inferior vena cava resection and reconstruction for Retroperitoneal Tumor excision
Journal of Vascular Surgery, 2011Co-Authors: William J Quinonesbaldrich, Ali Alktaifi, Fritz C EilberAbstract:OBJECTIVE: This study reviews the results of en bloc resection of the inferior vena cava (IVC) for malignant Tumor excision and reconstruction. METHODS: A prospective database was reviewed. IVC resection was categorized as suprarenal, perirenal, infrarenal, or extensive (>one segment resected). Repairs were divided into primary, patch, or circumferential. Tumor type, perioperative morbidity, mortality, and graft patency were recorded. RESULTS: Between 1990 and 2011, 47 patients (21 women; mean age, 56; range, 35-89 years) underwent IVC resection for en bloc Tumor excision. Sarcomas were most common (36 [77%]: 30 primary IVC). Eleven patients had primary IVC repair, nine patch repair (two autogenous), and 27 had circumferential replacement with a polytetrafluoroethylene ringed graft. Extensive IVC reconstruction in 18 patients included the entire IVC, with renal (RV) and hepatic vein reimplantation in eight; suprarenal and perirenal in six (seven RVs reimplanted); and infrarenal and perirenal in four (four RVs reimplanted). Nine single-segment IVC replacements were infrarenal. Morbidity was 10.6%: one each with bowel obstruction, chyle leak, renal failure with complete recovery (left RV reimplant, right nephrectomy), reoperation for bleeding, and IVC graft thrombosis. Morbidity did not differ by type of reconstruction. There was no mortality. Follow-up ranged from 1.5 to 216 months (18 years) with a mean of 3.5 years. Computed tomography or duplex scans were available in 28 of 47 patients and in 15 of 27 patients in group 3 at a mean follow-up of 36 and 20 months, respectively. One IVC graft thrombosis was documented at 10 months after chemotherapy/sepsis. Tumor recurrence caused three graft stenoses. Cumulative 5-year patency in group 3 was 80% (imaging) and 92% (clinical). Lower extremity edema was universally avoided. Cumulative 5-year survival for the series was 45% ± 8.5%. Mean long-term survival was 5.8 ± 0.56 years (range, 4 months-17 years), with a significant difference between primary or patch (mean, 6.5 years) and circumferential or extensive repair (mean, 4.2 years; P .12) survival was similar between patients with single-segment and extensive IVC resection and replacement. CONCLUSIONS: IVC resection and reconstruction for en bloc Tumor excision is safe, even when extensive repairs are necessary. Replacement of the IVC with prosthetic graft avoids extremity venous complications and likely contributes to quality of survival. Survival depends on Tumor behavior and degree of IVC involvement, where primary and patch repair has a better prognosis than circumferential resection.
William J Quinonesbaldrich - One of the best experts on this subject based on the ideXlab platform.
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techniques for inferior vena cava resection and reconstruction for Retroperitoneal Tumor excision
Journal of vascular surgery. Venous and lymphatic disorders, 2013Co-Authors: William J Quinonesbaldrich, Steven FarleyAbstract:Management of the inferior vena cava (IVC) after resection for treatment of Retroperitoneal sarcomas is controversial. Ligation is well tolerated if collateral circulation is preserved. These pathways, however, are often interrupted or resected during Tumor excision, and up to 50% of these patients will experience lower extremity edema with IVC ligation. We have favored IVC reconstruction, particularly when circumferential resection is necessary for complete Retroperitoneal Tumor removal. Our results with this approach have been recently updated, documenting that en bloc resection and reconstruction of the IVC can be performed with very low morbidity and mortality and is associated with a low incidence of postoperative symptoms of venous hypertension. This article describes our preferred techniques for the management of the IVC after partial or circumferential resection.
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inferior vena cava resection and reconstruction for Retroperitoneal Tumor excision
Journal of Vascular Surgery, 2011Co-Authors: William J Quinonesbaldrich, Ali Alktaifi, Fritz C EilberAbstract:OBJECTIVE: This study reviews the results of en bloc resection of the inferior vena cava (IVC) for malignant Tumor excision and reconstruction. METHODS: A prospective database was reviewed. IVC resection was categorized as suprarenal, perirenal, infrarenal, or extensive (>one segment resected). Repairs were divided into primary, patch, or circumferential. Tumor type, perioperative morbidity, mortality, and graft patency were recorded. RESULTS: Between 1990 and 2011, 47 patients (21 women; mean age, 56; range, 35-89 years) underwent IVC resection for en bloc Tumor excision. Sarcomas were most common (36 [77%]: 30 primary IVC). Eleven patients had primary IVC repair, nine patch repair (two autogenous), and 27 had circumferential replacement with a polytetrafluoroethylene ringed graft. Extensive IVC reconstruction in 18 patients included the entire IVC, with renal (RV) and hepatic vein reimplantation in eight; suprarenal and perirenal in six (seven RVs reimplanted); and infrarenal and perirenal in four (four RVs reimplanted). Nine single-segment IVC replacements were infrarenal. Morbidity was 10.6%: one each with bowel obstruction, chyle leak, renal failure with complete recovery (left RV reimplant, right nephrectomy), reoperation for bleeding, and IVC graft thrombosis. Morbidity did not differ by type of reconstruction. There was no mortality. Follow-up ranged from 1.5 to 216 months (18 years) with a mean of 3.5 years. Computed tomography or duplex scans were available in 28 of 47 patients and in 15 of 27 patients in group 3 at a mean follow-up of 36 and 20 months, respectively. One IVC graft thrombosis was documented at 10 months after chemotherapy/sepsis. Tumor recurrence caused three graft stenoses. Cumulative 5-year patency in group 3 was 80% (imaging) and 92% (clinical). Lower extremity edema was universally avoided. Cumulative 5-year survival for the series was 45% ± 8.5%. Mean long-term survival was 5.8 ± 0.56 years (range, 4 months-17 years), with a significant difference between primary or patch (mean, 6.5 years) and circumferential or extensive repair (mean, 4.2 years; P .12) survival was similar between patients with single-segment and extensive IVC resection and replacement. CONCLUSIONS: IVC resection and reconstruction for en bloc Tumor excision is safe, even when extensive repairs are necessary. Replacement of the IVC with prosthetic graft avoids extremity venous complications and likely contributes to quality of survival. Survival depends on Tumor behavior and degree of IVC involvement, where primary and patch repair has a better prognosis than circumferential resection.
Steven Farley - One of the best experts on this subject based on the ideXlab platform.
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techniques for inferior vena cava resection and reconstruction for Retroperitoneal Tumor excision
Journal of vascular surgery. Venous and lymphatic disorders, 2013Co-Authors: William J Quinonesbaldrich, Steven FarleyAbstract:Management of the inferior vena cava (IVC) after resection for treatment of Retroperitoneal sarcomas is controversial. Ligation is well tolerated if collateral circulation is preserved. These pathways, however, are often interrupted or resected during Tumor excision, and up to 50% of these patients will experience lower extremity edema with IVC ligation. We have favored IVC reconstruction, particularly when circumferential resection is necessary for complete Retroperitoneal Tumor removal. Our results with this approach have been recently updated, documenting that en bloc resection and reconstruction of the IVC can be performed with very low morbidity and mortality and is associated with a low incidence of postoperative symptoms of venous hypertension. This article describes our preferred techniques for the management of the IVC after partial or circumferential resection.
Constantinos Villias - One of the best experts on this subject based on the ideXlab platform.
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primary Retroperitoneal mucinous cystadenoma of borderline malignancy in a male patient case report and review of the literature
World Journal of Surgical Oncology, 2011Co-Authors: Evangelos Falidas, Stefanos Konstandoudakis, Konstantinos Vlachos, Fotios Archontovasilis, Stavros Mathioulakis, Stavros Boutzouvis, Constantinos VilliasAbstract:Background: Primary Retroperitoneal mucinous cystadenoma of borderline malignancy represents a rare Tumor, with unclear histogenesis, concerning almost exclusively women. Only two cases concerning male patients have been reported. Case report: We herein report a case of a 37 year old man undergone laparotomy for a sizable Retroperitoneal Tumor resulting after the histological examination to a primary Retroperitoneal mucinous cystadenoma of borderline malignancy. Conclusion: This is the third case of primary Retroperitoneal mucinous cystadenoma of borderline malignancy in a male patient reported in the literature. The preoperative diagnosis is impossible. Laparotomy constitutes the only diagnostic and curative approach.
Christina L Roland - One of the best experts on this subject based on the ideXlab platform.
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postoperative pancreatic fistula after distal pancreatectomy for non pancreas Retroperitoneal Tumor resection
American Journal of Surgery, 2020Co-Authors: Emily Z Keung, Elliot A Asare, Yiju Chiang, Laura R Prakash, Nikita Rajkot, Keila E Torres, Kelly K Hunt, Barry W Feig, Janice N Cormier, Christina L RolandAbstract:Abstract Introduction Short-term outcomes after distal pancreatectomy (DP) for Retroperitoneal (RP) Tumors are unknown. We sought to identify rates of postoperative pancreatic fistula (POPF) and morbidity after en bloc DP with RP Tumor resection. Methods A retrospective review of 43 patients who underwent DP with RP Tumor resection (1/2011–12/2017) was performed. Results Seventeen patients had RP sarcoma, 12 renal cell carcinoma, 11 gastrointestinal stromal Tumor, and 3 adrenocortical carcinoma. Grade III-IV complications occurred in 7 patients. Grade B POPF occurred in 14 patients, grade C POPF in none, and biochemical leak in 6. Of 22 patients who developed radiographically evident peri-pancreatic fluid collections, 7 required percutaneous drainage. The 90-day readmission rate was 33%. Conclusions DP with RP Tumor resection is associated with high rates of clinically relevant POPF compared to historical results for DP for primary pancreatic Tumors. Multi-center studies to identify targetable predictors and risk mitigation strategies for POPF in this rare high-risk population are needed.