Table 3.
Studies reporting about liver resections with outflow reconstruction: inferior vena cava, hepatic vein, or combined vena cava-hepatic vein reconstruction. IVC inferior vena cava; TVE total vascular exclusion; CRLM colorectal liver metastases; HCC hepatocellular carcinoma; CCC cholangiocarcinoma; iCC intrahepatic cholangiocarcinoma; RCC renal cell carcinoma; GIST gastroinestinal stroma tumor; HV hepatic vein; RHV right hepatic vein; PV portal vein
| Author | Year | Number of cases/indication | Mode of IVC resection | Technique of vascular reconstruction | Associated liver resections | In- hospital morbidity | In-hospital mortality | Survival rates |
|---|---|---|---|---|---|---|---|---|
| IVC reconstruction | ||||||||
| Miayazaki et al. [132] | 1999 |
n = 16 CRLM: n = 14 Met. gastric cancer: n = 1 Met. uterine cancer: n = 1 |
n = 16 n = 8 TVE n = 3 in situ cold perfusion n = 5 IVC side clamping All TVE > 30 min with venovenous bypass |
n = 13 primarily closure n = 2 patches n = 1 Gore tube |
n = 16 liver resections (12 major and 4 minor hepatectomies) |
25% | 6% |
CRLM: 1-year 82% 5-year 27% |
| Sarmiento et al. [110] | 2003 |
n = 18 CCC: n = 9 Metastases: n = 5 HCC: n = 2 Other: n = 2 |
5.5% (1 intraop. death) | 5-year: 21% | ||||
|
Azoulay et al [133] |
2006 |
n = 22 Liver metastases: n = 9 CCC: n = 8 HCC: n = 2 Others: n = 3 |
n = 22 IVC n = 1 TVE with preserved caval flow n = 12 TVE n = 9 in situ cold perfusion No ex situ resections n = 6 HV reimplantation |
n = 10 synthetic grafts n = 8 primary suture n = 4 caval plasty |
64% | 4.5% |
1-year 81.8% 5-year 38.3% |
|
| Malde et al. [102] | 2011 |
n = 35 CRLM: n = 21 HCC: n = 6 CCC: n = 3 Other: n = 5 |
n = 35 IVC Without TVE: n = 1 TVE n = 34 Cold perfusion: n = 22 ➢ 13 in situ ➢3 ante situm ➢6 ex situ |
n = 23 IVC patches n = 12 synthetic IVC grafts |
n = 30 major hepatectomies | 40% | 11% |
1-year 37.7% CRLM: 75.9% HCC: 83.3% CCC: 33.3% |
| Pulitano et al. [49] | 2013 |
n = 32 CRLM: n = 5 Leiomyosarcoma: n = 8 RCC: n = 11 Adrenal cancer: n = 2 HCC: n = 1 iCC: n = 2 GIST: n = 1 |
n = 32 IVC TVE n = 10 with HV or RV reimplantation Patch if < 30% circumference > 40% segment |
n = 22 segmental IVC graft n = 10 IVC patches (n = 10 bovine n = 22 peritoneum) |
n = 14 liver resections (7 major and 7 minor hepatectomies) n = 10 nephrectomy n = 2 pancreatico-duodenectomy |
28% | 9% |
1-year 78% 5-year 48% |
| Hemming et al. [51] | 2013 |
n = 60 CCC: n = 26 HCC: n = 16 CRLM: n = 13 GIST: n = 2 Hepatoblastoma: n = 2 Squamus cell carcinoma: n = 1 |
n = 60 IVC n = 1 tangential cava clamping n = 8 in situ cold perfusion n = 6 with HV/PV reco n = 3 with open pericardium All ex vivo resections with venovenous bypass |
IVC primarily 8 Tube graft 38 Patches 14 |
n = 60 major hepatectomies | 43% | 8% |
1-year 89% 5-year 35% |
| Hepatic vein reconstruction | ||||||||
|
Hemming et al [134] |
2002 |
n = 16 HCC: n = 9 CRLM: n = 5 CCC: n = 1 Hepatoblastoma: n = 1 |
N = 16 HV (10 entire venous outflow; 6 reco of RVH additionally) n = 5 combined with IVC n = 1 in situ cold perfusion n = 2 ex situ with venovenous bypass |
6 RHV (4 Gore) 10 major outflow (8 reimplanted, 2 using portal vein grafts) |
12% |
1-year 88% 3-year 50% |
||
| Saiura et al. [50] | 2011 |
n = 16 (CRLM) |
16 hepatectomies with HV reconstruction |
18 HV recos Saphenous 10 Direct anastomosis 1 External iliac vein 2 Portal vein 2 Umbilical vein patch graft 3 Ovarian vein patch graft 1 |
n = 5 major liver resections n = 11 minor liver resections |
50% | 0 |
1-year 93% 5-year 76% |