Surgery of the Inferior Vena Cava: A Multidisciplinary Approach

 

Description:

This book addresses an urgent need, offering an updated, detailed and multidisciplinary review of surgery of the inferior vena cava (IVC). Over the past two decades, tremendous advances have been made in this field and related specialties. Many journals and/or textbooks on different surgical or medical specialties have reported on individual aspects, so it is high time to gather all of them in a single resource. To date, surgery of the IVC remains a major challenge, not only in terms of technical difficulties, but also in terms of perioperative management.  The book sheds new light on cutting-edge developments, including: Innovations in imaging; Neoadjuvant and adjuvant treatments for tumors of or involving the IVC; Intraoperative anesthetic management; and Technical and technological advances in surgery. As such, it will be of a great interest to surgeons (cardiac, vascular and digestive) and urologists, as well as radiologists and anesthesiologists.

 

Table of Contents:

 

1: Imaging and Radiological Assessment of the Inferior Vena Cava

1.1 Introduction

1.2 IVC Imaging Techniques

1.2.1 Conventional Venography

1.2.2 Ultrasound

1.2.3 Multi-Detector Computed Tomography (MDCT)

1.2.4 Magnetic Resonance Imaging (MRI)

1.2.5 PET-CT

1.3 Main Imaging Diagnostic Feature

1.3.1 IVC Obstruction

1.3.1.1 Artifactual Filling Defect and Bland Thrombus

1.3.1.2 Benign Tumor Invasion Within the IVC

1.3.1.3 Malignant Tumor Invasion Within the IVC

1.3.1.4 IVC Obstruction Consequences and Therapeutic Implications

Budd-Chiari Syndrome

Collateral Pathways

1.3.2 IVC Anatomical Variants

1.3.2.1 Left IVC

1.3.2.2 Double IVC

1.3.2.3 Retrocaval Ureter

1.3.2.4 Retroaortic and Circumaortic Left Renal Vein

1.3.2.5 Interruption of the IVC and Azygos/Hemiazygos Continuation

1.3.2.6 Absence of the IVC

1.3.2.7 Portocaval Shunt

1.3.2.8 IVC Webs

1.3.3 IVC Trauma

1.3.4 Postoperative Imaging

1.3.4.1 Post-Liver Transplantation

1.3.4.2 Post-Portocaval Shunt

1.4 Interventional Imaging of the IVC

1.4.1 Inferior Vena Cava Filter

1.4.2 IVC Obstruction and Endovascular Management

References

2: Anesthetic and Hemodynamic Considerations of Inferior Vena Cava Surgery

2.1 Introduction

2.2 Anatomic and Physiologic Considerations on the IVC Circulation

2.2.1 Spontaneous Portocaval Shunts

2.2.1.1 Congenital Physiologic Bypasses

2.2.1.2 Acquired Shunts

2.2.2 Circulatory Models

2.2.2.1 Generalities

2.2.2.2 The “One-Compartment” Circulatory Model

2.2.2.3 The “Two-Compartment” Circulatory Model

2.3 The Different Venous Clampings

2.3.1 IVC Clamping Below the Renal Venous Confluence

2.3.2 IVC Clamping Above the Renal Venous Confluence (Below the Liver)

2.3.3 IVC Clamping Above the Hepatic Venous Confluence

2.3.4 Total Hepatic Vascular Exclusion

2.3.4.1 Hemodynamic Effects (Fig. 2.8)

2.3.4.2 Neurohormonal Effects

2.3.5 Inferior Vena Cava Clamping Combined with Supra-Celiac Aortic Clamping

2.4 The Role of the Anesthesiologist

2.4.1 Preoperative

2.4.2 Intraoperative

2.4.2.1 The Risk of Hemorrhage

2.4.2.2 The Risk of Gaseous Embolism

2.4.2.3 The Management of the Consequences of the Clamping

2.4.3 Postoperative

References

3: Primary Leiomyosarcoma of the Inferior Vena Cava

3.1 Introduction

3.2 Epidemiology, Etiology, and Predisposing Factors

3.3 Histopathology, Genetics, and Staging

3.4 Localization, Clinical Presentation, and Symptoms

3.5 Diagnostics

3.6 Treatment

3.6.1 Resection

3.6.2 A Resection Techniques

3.6.2.1 Limited Resection

3.6.2.2 Extended Resection (Single Organ Versus Multi-organ Resection)

3.6.3 Reconstruction Techniques

3.6.4 Morbidity and Mortality Rates

3.6.5 Neoadjuvant/Adjuvant Treatment

3.6.5.1 Chemotherapy

3.6.5.2 Radiotherapy

3.7 Oncological Outcomes and Prognostic Factors

References

4: Retroperitoneal Sarcoma Involving the Inferior Vena Cava

4.1 Introduction

4.2 Retroperitoneal Sarcoma

4.3 Technical Considerations on IVC Management

4.4 IVC Resection and Reconstruction

References

5: Renal Cell Carcinoma Involving the Inferior Vena Cava

5.1 Introduction

5.2 Clinical Presentation

5.3 Prognostic Factors

5.4 Imaging Diagnosis

5.5 Staging and Classification of Intracaval Extension

5.6 Patient Selection

5.7 Factors Determining the Choice of Surgical Technique

5.8 Preoperative Considerations

5.9 Surgical Steps and Technical Details

5.10 Adjunct Procedures: IVC Resection and Reconstruction

5.11 Postoperative Complications

5.12 Oncologic Outcomes After Radical Nephrectomy and Tumor Thrombectomy

References

6: Surgery of the Inferior Vena Cava Combined to Liver Resection

6.1 Introduction

6.2 General Principles

6.2.1 Caval Cross Clamping

6.2.2 Hemodynamic Changes of the Caval Cross Clamping

6.2.3 Hypothermic Perfusion Techniques

6.2.4 Venovenous Bypass

6.3 Perioperative Management

6.3.1 Anesthetic Management

6.3.2 Anticoagulation Protocol

6.4 Specific Technical Aspects

6.4.1 Total Vascular Exclusion of the Liver [4, 6, 7]

6.4.2 Hypothermic In Situ Liver Resection [10, 20, 25, 41]

6.4.3 Hypothermic Ante Situm Liver Resection [21, 24, 42–51]

6.4.4 Reperfusion

6.5 Surgical Indications and Outcomes

References

7: Ex Situ Resection of the Inferior Vena Cava with Hepatectomy

7.1 Introduction

7.2 Alternative Complex Techniques to Ex Situ Resection

7.2.1 In Situ Hypothermic Perfusion

7.2.2 The Ante Situm Procedure

7.3 Patient Assessment

7.3.1 Cardiorespiratory Assessment

7.3.2 Hepatic Reserve Assessment

7.3.3 Radiology Assessment

7.4 Preoperative Preparation

7.5 Anaesthesia

7.6 Operative Technique

7.6.1 Operability Assessment

7.6.2 Liver Mobilisation and Excision

7.6.3 Hepatic Perfusion and Preservation

7.6.4 Ex Situ Resection and Reconstruction

7.6.5 Hepatic Reimplantation and Reperfusion

7.7 Postoperative Care

7.8 Complications of Ex Situ Liver and IVC Resection

7.8.1 Vascular Thrombosis and Stenosis

7.8.2 Graft-Associated Sepsis

7.8.3 Biliary Strictures

7.9 Follow-Up

7.10 Long-Term Results

References

8: Surgical Treatment of Adrenocortical Carcinoma with Caval Invasion

8.1 Introduction

8.2 ACC and Inferior Vena Cava Extension

8.3 Preoperative Workup

8.4 Neoadjuvant Treatment

8.5 Surgical Management

8.5.1 Tumor Thrombus Located Below the Suprahepatic Veins

8.5.1.1 Thrombus Extension Limited to Infrahepatic IVC

8.5.1.2 Thrombus Extension to Retrohepatic IVC

8.5.2 Tumor Thrombus Extending Above the Suprahepatic Veins and Below the Cavo-Atrial Junction

8.5.3 Tumor Thrombus Is Located Above the Cavo-Atrial Junction

8.6 Results

References

9: Malignancy with Cavoatrial Extension

9.1 Introduction

9.2 Preoperative Staging

9.3 Surgical Technique

9.4 Postoperative Management

9.5 Discussion

References

10: Injuries of the Juxtahepatic Vena Cava

10.1 Introduction

10.2 Pattern of Injuries

10.3 Emergency Surgical Techniques in the Management of Retrohepatic Caval Injuries

10.3.1 Direct Suture

10.3.2 Vascular Exclusion of the Liver

10.3.3 Cavo-Caval Venous Bypass Procedures

10.3.4 Liver Resection to Obtain Access to the Retrohepatic Vena Cava

10.3.5 Perihepatic Packing (PHP)

10.3.6 Nonoperative Management

10.3.7 Liver Transplantation

10.4 Management Strategies

10.4.1 Hemodynamically Unstable Patient: Emergency Laparotomy Mandatory

10.4.2 Hemodynamically Stable Patient

References

11: Inferior Vena Cava Reconstruction in Liver Transplantation

11.1 Introduction

11.2 Conventional Vena Cava Technique

11.3 Venovenous Bypass

11.4 Piggyback Technique

11.5 Piggyback Variants: End-to-Side, Side-to-Side Cavocavostomy, and Reverse Piggyback

11.6 Piggyback Variant: Anterior Approach Hepatectomy

11.7 Temporary Portocaval Shunt

11.8 Reconstruction in Special Situations

11.8.1 Domino Transplantation

11.8.2 Budd-Chiari Syndrome

11.8.3 Outflow Obstruction

11.8.4 Split-Liver Transplantation

11.8.5 IVC as Source of Portal Inflow

References

12: Inferior Vena Cava Reconstruction in Living Donor Liver Transplantation

12.1 Introduction

12.2 Preservation and Preparation of Native IVC in LDLT

12.3 Outflow Reconstruction in LDLT

12.3.1 Right Liver

12.3.2 Left Liver

12.4 Orthotopic Position of the Partial Graft

12.5 Reconstruction of Short Hepatic Veins

12.6 Reconstruction of Middle Hepatic Vein Tributaries

12.7 Grafts Used to Reconstruct IVC, Autograft, Allograft, Cryopreserved Allograft, and Artificia

12.8 IVC Replacement in LDLT

12.9 IVC Reconstruction for Outflow Block

References

13: Vena Cava Filters: State of the Art

13.1 Introduction

13.2 History of the Vena Cava Filtration

13.3 Vena Cava Filter Classification

13.4 Indications for VCF Placement

13.4.1 Absolute Indications

13.4.2 Relative Indications

13.4.3 Prophylactic Indications

13.5 VCF Placement Procedure

13.6 VCF Retrieval Procedure

13.7 Efficiency

13.8 Long-Term Complications of VCF

13.9 Management of Patients with VCF and Strategies for Retrieval

References

 

An aparitie	26 April 2017
Autor	Daniel Azoulay , Chetana Lim, Chady Salloum
Dimensiuni	16.28 x 1.98 x 24.49 cm
Editura	Springer
Format	Hardcover
ISBN	9783319255637
Limba	Engleza
Nr pag	232