Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Sarcoma Center, Peking University Cancer Hospital and Institute, #52 Fu-Cheng-Lu Street, Hai-Dian District, Beijing, 100142, China.
Updates Surg. 2022 Jun;74(3):1157-1163. doi: 10.1007/s13304-020-00843-1. Epub 2020 Jun 29.
Complete resection for retroperitoneal sarcoma (RPS) involving major vessels frequently requires vascular resection and reconstruction. The use of artificial grafts often leads to postoperative vascular graft infection (VGI), which usually requires reoperation and sometimes leads to death. In the present study, the data of RPS patients who underwent contralateral iliac artery (IIA) transposition for reconstruction of the common iliac artery (CIA) after RPS resection from 2015-2019 were retrospectively analyzed. Clinical, intraoperative, and postoperative outcomes were described. Contralateral IIA transposition was performed to reconstruct the CIA after segmental resection in three patients. All patients underwent concomitant organ resection. Colon resection was performed for all patients, nephrectomy was performed for two patients, and segmental resection of the left ureter with transurethral ureterostomy was performed for one patient. Complete resection was achieved in all patients, and microscopic tumor infiltration to the CIA was observed in all patients (tunica adventitia: 2, tunica media: 1). No major complications occurred during the hospital stay. During the follow-up period (6.0-29.1 months), one patient died from tumor recurrence, and the other two patients did not have any evidence of recurrence or metastatic disease at the latest follow-up. The level of lower limb function was favorable (MSTS93 scores: 28-30). The pelvic organ functions, including bowel, bladder, and sexual functions, were not impaired in any of the patients. This novel technique in which contralateral IIA transposition is performed to reconstruct the CIA after RPS resection is simple and reliable and may be a good alternative to artificial grafts.
对于涉及主要血管的腹膜后肉瘤（RPS），完全切除通常需要进行血管切除和重建。人造移植物的使用常常导致术后血管移植物感染（VGI），这通常需要再次手术，有时甚至导致死亡。在本研究中，回顾性分析了 2015 年至 2019 年间因 RPS 切除后行同侧髂动脉（IIA）转位重建髂总动脉（CIA）的 RPS 患者的资料。描述了临床、术中及术后结果。在 3 例患者中，行节段性切除术切除 CIA 后，采用同侧 IIA 转位重建 CIA。所有患者均同时行器官切除术。所有患者均行结肠切除术，2 例行肾切除术，1 例行左输尿管节段切除伴经尿道输尿管造口术。所有患者均达到完全切除，且所有患者均观察到 CIA 有肿瘤浸润（外膜：2 例，中膜：1 例）。患者住院期间无重大并发症发生。在随访期间（6.0-29.1 个月），1 例患者死于肿瘤复发，另 2 例患者在最近一次随访时均无复发或转移证据。下肢功能良好（MSTS93 评分：28-30）。所有患者的盆脏器官功能（包括肠、膀胱和性功能）均未受损。该技术是一种将对侧 IIA 转位用于 RPS 切除后重建 CIA 的新技术，简单可靠，可能是人造移植物的良好替代方案。
