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Thoracoabdominal Aortic Replacement Together with Curative Oncological Surgery in Retroperitoneal and Spinal Tumours

Malignancies with an extended encasement or infiltration of the aorta were previously considered inoperable. This series demonstrates replacement and subsequent resection of the thoracoabdominal aorta and its large branches as an adjunct to curative radical retroperitoneal and spinal tumor resection...

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Autores principales: Lutz, Brigitta M., Schaser, Klaus-Dieter, Weitz, Jurgen, Kirchberg, Johanna, Fritzsche, Hagen, Disch, Alexander C., Busch, Albert, Wolk, Steffen, Reeps, Christian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10047559/
https://www.ncbi.nlm.nih.gov/pubmed/36975408
http://dx.doi.org/10.3390/curroncol30030195
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author Lutz, Brigitta M.
Schaser, Klaus-Dieter
Weitz, Jurgen
Kirchberg, Johanna
Fritzsche, Hagen
Disch, Alexander C.
Busch, Albert
Wolk, Steffen
Reeps, Christian
author_facet Lutz, Brigitta M.
Schaser, Klaus-Dieter
Weitz, Jurgen
Kirchberg, Johanna
Fritzsche, Hagen
Disch, Alexander C.
Busch, Albert
Wolk, Steffen
Reeps, Christian
author_sort Lutz, Brigitta M.
collection PubMed
description Malignancies with an extended encasement or infiltration of the aorta were previously considered inoperable. This series demonstrates replacement and subsequent resection of the thoracoabdominal aorta and its large branches as an adjunct to curative radical retroperitoneal and spinal tumor resection. Five consecutive patients were enrolled between 2016 and 2020, suffering from cancer of unknown primary, pleomorphic carcinoma, chordoma, rhabdoid sarcoma, and endometrial cancer metastasis. Wide surgical resection was the only curative option for these patients. For vascular replacement, extracorporeal membrane oxygenation (ECMO) was used as a partial left-heart bypass. The early technical success rate was 100% for vascular procedures and all patients underwent complete radical tumour resection with negative margins. All patients required surgical revision (liquor leak, n = 2; hematoma, n = 3; bypass revision, n = 1; bleeding, n = 1; biliary leak, n = 1). During follow-up (average 47 months, range 22–70) primary patency rates of aortic reconstructions and arterial bypasses were 100%; no patient suffered from recurrent malignant disease. Thoracoabdominal aortic replacement with rerouting of visceral and renal vessels is feasible in oncologic patients. In highly selected young patients, major vascular surgery can push the limits of oncologic surgery further, allowing a curative approach even in extensive retroperitoneal and spinal malignancies.
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spelling pubmed-100475592023-03-29 Thoracoabdominal Aortic Replacement Together with Curative Oncological Surgery in Retroperitoneal and Spinal Tumours Lutz, Brigitta M. Schaser, Klaus-Dieter Weitz, Jurgen Kirchberg, Johanna Fritzsche, Hagen Disch, Alexander C. Busch, Albert Wolk, Steffen Reeps, Christian Curr Oncol Article Malignancies with an extended encasement or infiltration of the aorta were previously considered inoperable. This series demonstrates replacement and subsequent resection of the thoracoabdominal aorta and its large branches as an adjunct to curative radical retroperitoneal and spinal tumor resection. Five consecutive patients were enrolled between 2016 and 2020, suffering from cancer of unknown primary, pleomorphic carcinoma, chordoma, rhabdoid sarcoma, and endometrial cancer metastasis. Wide surgical resection was the only curative option for these patients. For vascular replacement, extracorporeal membrane oxygenation (ECMO) was used as a partial left-heart bypass. The early technical success rate was 100% for vascular procedures and all patients underwent complete radical tumour resection with negative margins. All patients required surgical revision (liquor leak, n = 2; hematoma, n = 3; bypass revision, n = 1; bleeding, n = 1; biliary leak, n = 1). During follow-up (average 47 months, range 22–70) primary patency rates of aortic reconstructions and arterial bypasses were 100%; no patient suffered from recurrent malignant disease. Thoracoabdominal aortic replacement with rerouting of visceral and renal vessels is feasible in oncologic patients. In highly selected young patients, major vascular surgery can push the limits of oncologic surgery further, allowing a curative approach even in extensive retroperitoneal and spinal malignancies. MDPI 2023-02-21 /pmc/articles/PMC10047559/ /pubmed/36975408 http://dx.doi.org/10.3390/curroncol30030195 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Lutz, Brigitta M.
Schaser, Klaus-Dieter
Weitz, Jurgen
Kirchberg, Johanna
Fritzsche, Hagen
Disch, Alexander C.
Busch, Albert
Wolk, Steffen
Reeps, Christian
Thoracoabdominal Aortic Replacement Together with Curative Oncological Surgery in Retroperitoneal and Spinal Tumours
title Thoracoabdominal Aortic Replacement Together with Curative Oncological Surgery in Retroperitoneal and Spinal Tumours
title_full Thoracoabdominal Aortic Replacement Together with Curative Oncological Surgery in Retroperitoneal and Spinal Tumours
title_fullStr Thoracoabdominal Aortic Replacement Together with Curative Oncological Surgery in Retroperitoneal and Spinal Tumours
title_full_unstemmed Thoracoabdominal Aortic Replacement Together with Curative Oncological Surgery in Retroperitoneal and Spinal Tumours
title_short Thoracoabdominal Aortic Replacement Together with Curative Oncological Surgery in Retroperitoneal and Spinal Tumours
title_sort thoracoabdominal aortic replacement together with curative oncological surgery in retroperitoneal and spinal tumours
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10047559/
https://www.ncbi.nlm.nih.gov/pubmed/36975408
http://dx.doi.org/10.3390/curroncol30030195
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