Outcomes of inferior vena cava reconstruction using artificial or autologous materials in ex vivo liver resection and autotransplantation |
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Institution: | 1. Department of Liver Surgery & Liver Transplantation Center, West China Hospital of Sichuan University, Chengdu, PR China;2. Department of Vascular Surgery, West China Hospital of Sichuan University, Chengdu, PR China;3. Clinical Research Center of Hydatidosis, Ganze Prefecture, Sichuan Province, China |
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Abstract: | BackgroundThe use of artificial or autologous materials for inferior vena cava (IVC) reconstruction is controversial. This study retrospectively explored the effects of different materials on perioperative outcomes.MethodsThis study included 91 patients who underwent IVC reconstruction during liver autotransplantation between 2014 and 2020. A univariate analysis was performed to select variables affecting postoperative morbidity. The effect of IVC reconstruction materials on perioperative outcomes was tested with a multivariable generalized linear model. The effects on postoperative morbidity and operation time were further tested with the multivariate regression analysis based on the generalized estimating equation. Adjusted models were used in all analyses.ResultsA median operation time of 710 (633–790) min, a median blood loss of 2200 (1550–3000) mL, an incidence of 33% (30/91) for major morbidities and a median comprehensive complication index (CCI) of 0.0 (0.0–26.2) were observed, with no IVC reconstruction-related complications postoperatively or in the long term. The IVC reconstruction material had no significant effect on postoperative outcomes, while artificial materials significantly increased inpatient cost (191 ± 35 vs. 164 ± 36 k Yuan, p < 0.001). The multivariate regression revealed a significant shift in outcomes of operation time (p = 0.0368).DiscussionArtificial grafts are recommended for IVC reconstruction if cost is not a factor. |
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Keywords: | Autotransplantation Alveolar echinococcosis Ex vivo resection Living donor Vascular reconstruction CT"} {"#name":"keyword" "$":{"id":"kwrd0040"} "$$":[{"#name":"text" "_":"Computed tomography ELRA"} {"#name":"keyword" "$":{"id":"kwrd0050"} "$$":[{"#name":"text" "_":"ex vivo liver resection and autotransplantation ePTFE"} {"#name":"keyword" "$":{"id":"kwrd0060"} "$$":[{"#name":"text" "_":"expanded polytetrafluoroethylene HAE"} {"#name":"keyword" "$":{"id":"kwrd0070"} "$$":[{"#name":"text" "_":"hepatic alveolar echinococcosis IVC"} {"#name":"keyword" "$":{"id":"kwrd0080"} "$$":[{"#name":"text" "_":"inferior vena cava RHVC"} {"#name":"keyword" "$":{"id":"kwrd0090"} "$$":[{"#name":"text" "_":"retrohepatic inferior vena cava |
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