The Surgical Management of Primary Peritoneal Tumor Involving Iliac Vessels_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

CHEN Xiyang ,  ZHAO Jichun , MA Yukui , HUANG Bin , YANG Yi , YUAN Ding , WU Zhoupeng

The Center of Vascular Surgery， West China Hospital， Sichuan University， Chengdu 610041， Sichuan Province， China;

Corresponding author：

ZHAO Jichun, Email: sunsetcxy@gmail.com

Keywords：

Retroperitoneal tumors; Iliac vessels reconstruction; Surgical operation

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Objective 　To discuss the surgical management in resection of primary peritoneal tumors involving iliac vessels.
Methods 　The clinical data of 124 patients with primary peritoneal tumors involving iliac vessels， that underwent surgical procedures from December 2006 to December 2011 were analyzed retrospectively. There were 68 men
and 56 women with an age raging from 16-72 years old （mean 44 years old）.
Results 　All patients underwent operative treatment. Fifty-two patients with tumors infiltrating or surrounding the major illiac vessels， 72 patients with tumors compressing the iliac vessels. Primary peritoneal tumors involving iliac vessels were completely resected in 90 patients， were incompletely resected in 31 patients， and were palliatively resected in 3 patients. Resectoin of primary peritoneal tumors and iliac vessel reconstruction were performed in 42 patients with tumors infiltrating or surrounding the major illiac vessels. There was no death during perioperative period. There were complications in 2 patients， that including urinary fistula in 1 patient and fat liquefaction of incision in 1 patient. Complications were not found in the rest of the patients. All patients were followed-up from 12-24 months （mean 16 months）. Thirty-eight patients relapsed locally in 90 patients with tumor completely resected. Nine patients died in those tumor incompletely resected（6 patients died because of recurrence， 3 patients died because of cadiovasuclar and cerebrovascular accidents）. Three patients follwing palliative resected were dead during the follow-up period （3 patients died because of recurrence）. Among the 42 patients underwent the procedure of iliac vessels， recurrence occured in 3 patients without involving iliac vessels， 1 patient relapsed involving inferior vena cava （IVC） which resulted in IVC obstruction and deep venous thrombosis following 7 months after operation. Recurrence occured in 2 patients involving common iliac veins following 8 months after operation. Venous thrombus of common iliac vein graft occured in 1 patientin in 10 months after operation.
Conclusion 　Resection completely and involved iliac vessel reconstruction would reduce recurrence of tumor and promote long term survival in patients with primary peritoneal tumors involving iliac vessels

Citation： CHEN Xiyang,ZHAO Jichun,MA Yukui,HUANG Bin,YANG Yi,YUAN Ding,WU Zhoupeng,.. The Surgical Management of Primary Peritoneal Tumor Involving Iliac Vessels. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2013, 20(7): 768-771. doi: Copy

1.	黄斌，赵纪春，马玉奎. 原发性腹膜后肿瘤的诊断和治疗[J] . 中国普外基础与临床， 2008， 15(8)：607-608.
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3.	曲思凤，李涛，赵蒙，等. 原发性腹膜后肿瘤的诊断与治疗[J]. 中国现代普通外科进展， 2011， 14(2)：116-118.
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5.	Anaya-Ayala JE， Cheema ZF， Davies MG， et al. Concomitant reconstruction of infrarenal aorta and inferior vena cava after en bloc resection of retroperitoneal rhabdomyosarcoma[J]. Vasc Endovascular Surg， 2011， 45(8)：769-772.
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14.	Faĭnshteĭn IA， Nechushkin MI， Gorobets ES， et al. Resection and prosthetics of abdominal aorta by surgical treatment of invasiveretroperitoneal tumors[J]. Khirurgiia (Mosk)， 2010， (6)：26-30，i-ii.
15.	李滨，陈福真，杨珏. 利用血管外科技术提高腹膜后肿瘤完整切除率[J]. 中国血管外科杂志， 2012， 4(2)：95-104.
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17.	Daab LJ， Cook P， Woo K， et al. Management of a catecholamine-secreting paraganglioma requiring aortic reconstruction[J]. Vasc Endovascular Surg， 2010， 44(2)：150-154.
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19.	Schwarzbach MH， Hormann Y， Hinz U， et al. Clinical results of surgery for retroperitoneal sarcoma with major blood vessel invol-vement[J]. J Vasc Surg， 2006， 44(1)：46-55.
20.	Fueglistaler P， Gurke L， Stierli P， et al. Major vascular resection and prosthectic replacement for retroportional tumors[J]. World J Surg， 2006， 30（7）：1344-1349.
21.	Schneider JR， Sener SF， Barrera E Jr. Combined replacement of infrarenal aorta and inferior vena cava after en bloc resection of retroperitoneal extraosseous osteosarcoma[J]. J Vascul Surg， 2008， 48(2)：478-479.
22.	Ouellette JR， C ossman DV， Sibert KS， et al. Tumors at the aortoiliac/inferior vena cava bifurcation， preoperative anesthetic and intaoperative considerations[J]. Am Surg， 2007， 73(5)：440-446.
23.	Ohman JW， Chandra V， Poultsides G， et al. Iliocaval and aorto-iliac reconstruction following en bloc retroperitoneal leiomyosarcoma resection[J]. J Vasc Surg， 2013， 57(3)：850.
24.	Stella M， Gandini A， Meeus P， et al. Retroperitoneal vascular surgery for the treatment of giant growing teratoma syndrome[J]. Urology， 2012， 79(2)：365-370.
25.	Chikatani K， Baba H， Sobajima J， et al. Clinicopathological characteristics and treatment outcome of retroperitoneal liposarcoma[J]. Gan To Kagaku Ryoho， 2012， 39(12)：2426-2428.
26.	Bates SM， Greer IA， Middeldorp S， et al. VTE， thrombophilia， antithrombotic therapy， and pregnancy：antithrombotic therapy and prevention of thrombosis， 9th ed：American College of Chest Physicians Evidence-Based Clinical Practice Guidelines[J]. Chest， 2012， 141(2 Suppl)：e691S- e736S.

1. 黄斌，赵纪春，马玉奎. 原发性腹膜后肿瘤的诊断和治疗[J] . 中国普外基础与临床， 2008， 15(8)：607-608.
2. 蒋彦永，罗成华. 原发性腹膜后肿瘤外科学理论与实践[M] . 北京：人民军医出版社， 2006：47-86.
3. 曲思凤，李涛，赵蒙，等. 原发性腹膜后肿瘤的诊断与治疗[J]. 中国现代普通外科进展， 2011， 14(2)：116-118.
4. 戈小虎，亚力坤，李雪松，等. 腹膜后肿瘤联合血管切除重建29例临床应用[J]. 中华疝和腹壁外科杂志， 2011， 5(1)：31-36.
5. Anaya-Ayala JE， Cheema ZF， Davies MG， et al. Concomitant reconstruction of infrarenal aorta and inferior vena cava after en bloc resection of retroperitoneal rhabdomyosarcoma[J]. Vasc Endovascular Surg， 2011， 45(8)：769-772.
6. 郭伟，张宏鹏. 血管外科技术在腹膜后肿瘤诊疗中的应用[J]. 中华外科杂志， 2008， 4(28)：301-303.
7. Ghosh J， Bhowmick A， Baguneid M. Oncovascular surgery[J]. Eur J Surg Oncol， 2011， 37（12）：1017-1024.
8. Wallis F， Gilbert FJ. Magnetic resonance imaging in oncology：an overview[J]. J R Coll Surg Edinb， 1999， 44（2）：117-125.
9. Salai M， Garniek A， Rubinstein Z， et al. Preoperative angiography and embolization of large pelvictumors[J]. J Surg Oncol， 1999， 70（1）：41-44.
10. Harisinghani MG， Saini S， Weissleder R， et al. MR lymphangiography using ultrasmall superparamagnetic ironoxide in patients with primary abdominal and pelvic malignancies[J]. AJR Am J Roentgenol， 1999， 172（5）：1347-1351.
11. Fiore M， Colombo C， Locati P， et al. Surgical technique， morbidity， and outcome of primary retroperitoneal sarcoma involving inferior vena cava[J]. Ann Surg Oncol， 2012， 19(2)：511-518.
12. Quinones-Baldrich W， Alktaifi A， Eilber F， et al. Inferior vena cava resection and reconstruction for retroperitoneal tumor excision[J]. J Vasc Surg， 2012， 55(5)：1386-1393.
13. Tseng WW， Wang SC， Eichler CM， et al. Complete and safe resection of challenging retroperitoneal tumors：anticipation of multi-organ and major vascular resection and use of adjunct procedures[J]. World J Surg Oncol， 2011， 9：143.
14. Faĭnshteĭn IA， Nechushkin MI， Gorobets ES， et al. Resection and prosthetics of abdominal aorta by surgical treatment of invasiveretroperitoneal tumors[J]. Khirurgiia (Mosk)， 2010， (6)：26-30，i-ii.
15. 李滨，陈福真，杨珏. 利用血管外科技术提高腹膜后肿瘤完整切除率[J]. 中国血管外科杂志， 2012， 4(2)：95-104.
16. Tameo MN， Calligaro KD， Antin L， et al. Primary leiomyosarcoma of the inferior vena cava：reports of infrarenal and suprahepatic caval involvement[J]. J Vasc Surg， 2010， 51(1)：221-224.
17. Daab LJ， Cook P， Woo K， et al. Management of a catecholamine-secreting paraganglioma requiring aortic reconstruction[J]. Vasc Endovascular Surg， 2010， 44(2)：150-154.
18. Angermeter KW， Ross JH， Novick AC， et al. Resection of nonrenal retroperitoneal tumors with large vena caval thrombi using cardiopulmonary bypass and hypothermic circulatory arrest[J]. J Urol. 1990， 144(3)：735-739.
19. Schwarzbach MH， Hormann Y， Hinz U， et al. Clinical results of surgery for retroperitoneal sarcoma with major blood vessel invol-vement[J]. J Vasc Surg， 2006， 44(1)：46-55.
20. Fueglistaler P， Gurke L， Stierli P， et al. Major vascular resection and prosthectic replacement for retroportional tumors[J]. World J Surg， 2006， 30（7）：1344-1349.
21. Schneider JR， Sener SF， Barrera E Jr. Combined replacement of infrarenal aorta and inferior vena cava after en bloc resection of retroperitoneal extraosseous osteosarcoma[J]. J Vascul Surg， 2008， 48(2)：478-479.
22. Ouellette JR， C ossman DV， Sibert KS， et al. Tumors at the aortoiliac/inferior vena cava bifurcation， preoperative anesthetic and intaoperative considerations[J]. Am Surg， 2007， 73(5)：440-446.
23. Ohman JW， Chandra V， Poultsides G， et al. Iliocaval and aorto-iliac reconstruction following en bloc retroperitoneal leiomyosarcoma resection[J]. J Vasc Surg， 2013， 57(3)：850.
24. Stella M， Gandini A， Meeus P， et al. Retroperitoneal vascular surgery for the treatment of giant growing teratoma syndrome[J]. Urology， 2012， 79(2)：365-370.
25. Chikatani K， Baba H， Sobajima J， et al. Clinicopathological characteristics and treatment outcome of retroperitoneal liposarcoma[J]. Gan To Kagaku Ryoho， 2012， 39(12)：2426-2428.
26. Bates SM， Greer IA， Middeldorp S， et al. VTE， thrombophilia， antithrombotic therapy， and pregnancy：antithrombotic therapy and prevention of thrombosis， 9th ed：American College of Chest Physicians Evidence-Based Clinical Practice Guidelines[J]. Chest， 2012， 141(2 Suppl)：e691S- e736S.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

The Surgical Management of Primary Peritoneal Tumor Involving Iliac Vessels

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