https://www.giejournal.org/article/S0016-5107(04)02278-3/pdf

Self-expanding plastic stents for benign esophageal lesions.

Background:
Liver tumors with inferior vena cava (IVC) involvement may require combined resection of the liver and IVC. This approach, with its high surgical risks and poor long-term prognosis, was precluded until the development of neoadjuvant chemotherapy, portal vein embolization, reinforced vascular prostheses, and technical advances in liver transplantation.

/pdf/combined-liver-resection-and-reconstruction-of-the-supra-5cnszrf2qg.pdf

Combined Liver Resection and Reconstruction of the Supra-Renal Vena Cava: The Paul Brousse Experience

Electrocautery therapy for refractory anastomotic strictures of the esophagus.

Tools for endoscopic stricture dilation

Objective
The aim of this study was to evaluate the clinical outcome of hepatectomy combined with inferior vena cava (IVC) resection and reconstruction for treatment of invasive liver tumours.

Inferior vena cava resection with hepatectomy: challenging but justified

Endoscopic balloon dilation for benign esophageal anastomotic stricture

A 69 year-old man with a history of thoracoplastic surgery for pulmonary tuberculosis, who required a blood transfusion and subsequently tested positive for hepatitis C virus, developed a right hypochondrial mass, swelling of the lower extremities and malaise. A huge hepatocellular carcinoma invading the suprahepatic vena cava with tumor thrombi was diagnosed radiographically. An extended right hepatectomy with supra- to retrohepatic IVC resection was performed in an en bloc fashion using a centrifugal pump for hepatic vascular exclusion (HVE). The supra- to retrohepatic IVC was replaced with an expanded polytetrafluoroethylene (ePTFE) graft, 20 mm x 10 cm in size, and the left hepatic venous confluence was reconstructed. Twenty-one months after surgery, the patient is in good condition without recurrence of tumor.

Extended hepatectomy with ePTFE graft vena caval replacement and hepatic vein reconstruction: a case report.

Background/aims To preserve remnant liver function, extended left hepatectomy combined with middle hepatic vein reconstruction using a left renal vein graft was performed in resection of liver metastasis from sigmoid colon cancer, involving the confluence of the middle and left hepatic veins. Methodology The tumor, 5 cm in size, occupied the superior part of segment 4, and involved the confluence of the middle and the left hepatic veins. An extended left hepatectomy, including the left lobe, left caudate lobe and part of segment 8, together with the middle hepatic vein trunk, was performed. The left renal vein was resected as a graft from the confluence of the inferior vena cava just distal to the branches of the gonadal vein, renal-azygos, splenorenal communications and vertebral veins. The middle hepatic vein was reconstructed using the left renal vein 3 cm in length. Results Impaired values of liver function tests were normalized by the third postoperative day. Renal function was good throughout the postoperative period. The patient was discharged two weeks after the surgery. The reconstructed middle hepatic vein was patent, which was evaluated by a color Doppler ultrasonography, computed tomography and magnetic resonance imaging 60 days after the surgery. The patient remained well in the eight months thereafter. Conclusions Hepatic vein reconstruction using a left renal vein graft is a new and preferable addition for the selection of an optimal graft.

Hepatic vein reconstruction at inferior vena cava confluence using left renal vein graft.

BACKGROUND/AIMS Glutaraldehyde-fixed heterologous pericardium has been widely used for grafts in cardiac surgery. We applied it for inferior vena cava (IVC) patch grafting following combined resection of the liver and the IVC. METHODOLOGY IVC grafting using a glutaraldehyde-fixed horse pericardium following combined resection of the liver and the IVC was performed in 2 patients--one with hepatocellular carcinoma and the other with hepatic metastasis following rectal cancer. The retrohepatic vena cava defect was closed with a 10 x 5 cm patch in one patient and a 7 x 4 cm patch in the other. RESULTS Hepatic vascular exclusion was avoided in both patients. The IVC exclusion period was 40 min for the first patient and 25 min for the second. One patient required a veno-venous bypass with an active centrifugal pump of 153 min. There was no complication and no graft infection. The microscopic extension to the IVC was evident in one patient, and fibrous adhesive was evident in the IVC wall of the other. One patient died of hepatic failure 3 years and 6 months after surgery, and the other died of hepatic recurrence 7 months after surgery. Both grafts were patent, without calcification and stricture, until the patients' death. CONCLUSIONS Glutaraldehyde-fixed heterologous pericardium is an option for IVC grafting.

Glutaraldehyde-fixed heterologous pericardium for vena cava grafting following hepatectomy.

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Papers

Endoscopic balloon dilation for benign esophageal anastomotic stricture

Extended hepatectomy with ePTFE graft vena caval replacement and hepatic vein reconstruction: a case report.

Hepatic vein reconstruction at inferior vena cava confluence using left renal vein graft.

Glutaraldehyde-fixed heterologous pericardium for vena cava grafting following hepatectomy.