Vena Caval Reconstruction During Postchemotherapy Retroperitoneal Lymph Node Dissection for Metastatic Germ Cell Tumor

• Published in: Urology (Ridgewood, N.J.) Vol. 73; no. 2; pp. 442.e17 - 442.e19
• Main Authors: Ehrlich, Yaron, Kedar, Daniel, Zelikovski, Avigdor, Konichezky, Miriam, Baniel, Jack
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.02.2009
• Subjects: Adult; Combined Modality Therapy; Humans; Lymph Node Excision; Male; Middle Aged; Neoplasms, Germ Cell and Embryonal - drug therapy; Neoplasms, Germ Cell and Embryonal - secondary; Neoplasms, Germ Cell and Embryonal - surgery; Testicular Neoplasms - drug therapy; Testicular Neoplasms - pathology; Testicular Neoplasms - surgery; Urology; Vena Cava, Inferior - surgery; Young Adult
• ISSN: 0090-4295; 1527-9995; 1527-9995
• DOI: 10.1016/j.urology.2008.02.054

We present our experience with inferior vena cava (IVC) reconstruction in patients undergoing post-chemotherapy retroperitoneal lymph node dissection (PC-RPLND) due to metastatic germ cell tumor. Four patients underwent IVC reconstruction with a prosthetic graft. Early postoperative leg edema was prevented in all 4. Long-term graft patency was maintained in 3 patients, who remained free of chronic venous disorders for a median follow-up of 19 months (range of 13-55 months). In a fourth patient, graft occlusion was noted during follow up, caused by compression of the graft by a recurrent tumor. We conclude that when resection of the IVC is indicated during PC-RPLND, replacement by a prosthetic graft may prevent immediate postoperative leg edema and later chronic venous insufficiency.