Oncovascular surgery: first two case reports and teamwork perspective
BACKGROUND: Surgical resection remains the cornerstone for the curative treatment of malignant tumors, such as pancreatic adenocarcinomas. Pancreaticoduodenectomy with vascular reconstruction is a promising approach for tumors invading the portomesenteric vein, and an aggressive surgical approach ca...
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| Format: | Article |
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Sociedade Portuguesa de Angiologia e Cirurgia Vascular
2025-04-01
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| Series: | Angiologia e Cirurgia Vascular |
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| Online Access: | https://acvjournal.com/index.php/acv/article/view/581 |
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| author | Jacinta Maria Campos Joana Ferreira José P. Pinto André Marçal Nádia Tenreiro Tiago Castro Fernando Próspero Luís Machado |
| author_facet | Jacinta Maria Campos Joana Ferreira José P. Pinto André Marçal Nádia Tenreiro Tiago Castro Fernando Próspero Luís Machado |
| author_sort | Jacinta Maria Campos |
| collection | DOAJ |
| description | BACKGROUND: Surgical resection remains the cornerstone for the curative treatment of malignant tumors, such as pancreatic adenocarcinomas. Pancreaticoduodenectomy with vascular reconstruction is a promising approach for tumors invading the portomesenteric vein, and an aggressive surgical approach can improve survival in the mid- and long terms. Thus, vascular surgeons have an increasing role in these surgeries. Therefore, we describe our recent and initial experience and efforts to grow as a true team to offer a better and more systematic response to these patients.
CASE REPORTS: We present two cases of 68 and 69-year-old female patients, both with pancreatic head adenocarcinoma. In the first case, during the pancreaticoduodenectomy, a 4 cm long involvement of the portomesenteric vein in 50% of its circumference was denoted. The choice for reconstruction after tumor resection was a primary repair with a Dacron patch. In the second case, the resection was programmed after neoadjuvant chemotherapy, and a circumferential involvement of the portomesenteric vein in a long extension was observed, requiring an extensive venous reconstruction with an interposition graft (Dacron - 8mm) with splenic vein reimplantation.
In both cases, disease-free margins were achieved, and no mortality was registered within 30 days after surgery.
CONCLUSIONS: With these two initial cases, we concluded that good results can be achieved. Our center's team is working to preoperatively delineate our strategy for treating these complex patients, choosing optimal vascular reconstructive options tailored to each patient. Recently, a bovine pericardium patch became available in our institution, which is a good alternative to avoid additional operative time and reduce the infection risk associated with synthetic material use. |
| format | Article |
| id | doaj-art-f26c6dfbd4d246b8b3c87699fa8d5930 |
| institution | OA Journals |
| issn | 1646-706X 2183-0096 |
| language | Portuguese |
| publishDate | 2025-04-01 |
| publisher | Sociedade Portuguesa de Angiologia e Cirurgia Vascular |
| record_format | Article |
| series | Angiologia e Cirurgia Vascular |
| spelling | doaj-art-f26c6dfbd4d246b8b3c87699fa8d59302025-08-20T02:09:27ZporSociedade Portuguesa de Angiologia e Cirurgia VascularAngiologia e Cirurgia Vascular1646-706X2183-00962025-04-0120410.48750/acv.581Oncovascular surgery: first two case reports and teamwork perspectiveJacinta Maria Campos0Joana Ferreira1José P. Pinto2André Marçal3Nádia Tenreiro4Tiago Castro5Fernando Próspero6Luís Machado7Angiology and Vascular Surgery Department, Centro Hospitalar de Trás-os-Montes e Alto Douro, Vila Real, PortugalAngiology and Vascular Surgery Department, Centro Hospitalar de Trás-os-Montes e Alto Douro, Vila Real, PortugalAngiology and Vascular Surgery Department, Centro Hospitalar de Trás-os-Montes e Alto Douro, Vila Real, PortugalGeneral Surgery Department, Centro Hospitalar de Trás-os-Montes e Alto Douro, Vila Real, PortugalGeneral Surgery Department, Centro Hospitalar de Trás-os-Montes e Alto Douro, Vila Real, PortugalGeneral Surgery Department, Centro Hospitalar de Trás-os-Montes e Alto Douro, Vila Real, PortugalGeneral Surgery Department, Centro Hospitalar de Trás-os-Montes e Alto Douro, Vila Real, PortugalAngiology and Vascular Surgery Department, Centro Hospitalar de Trás-os-Montes e Alto Douro, Vila Real, PortugalBACKGROUND: Surgical resection remains the cornerstone for the curative treatment of malignant tumors, such as pancreatic adenocarcinomas. Pancreaticoduodenectomy with vascular reconstruction is a promising approach for tumors invading the portomesenteric vein, and an aggressive surgical approach can improve survival in the mid- and long terms. Thus, vascular surgeons have an increasing role in these surgeries. Therefore, we describe our recent and initial experience and efforts to grow as a true team to offer a better and more systematic response to these patients. CASE REPORTS: We present two cases of 68 and 69-year-old female patients, both with pancreatic head adenocarcinoma. In the first case, during the pancreaticoduodenectomy, a 4 cm long involvement of the portomesenteric vein in 50% of its circumference was denoted. The choice for reconstruction after tumor resection was a primary repair with a Dacron patch. In the second case, the resection was programmed after neoadjuvant chemotherapy, and a circumferential involvement of the portomesenteric vein in a long extension was observed, requiring an extensive venous reconstruction with an interposition graft (Dacron - 8mm) with splenic vein reimplantation. In both cases, disease-free margins were achieved, and no mortality was registered within 30 days after surgery. CONCLUSIONS: With these two initial cases, we concluded that good results can be achieved. Our center's team is working to preoperatively delineate our strategy for treating these complex patients, choosing optimal vascular reconstructive options tailored to each patient. Recently, a bovine pericardium patch became available in our institution, which is a good alternative to avoid additional operative time and reduce the infection risk associated with synthetic material use.https://acvjournal.com/index.php/acv/article/view/581Pancreatic head adenocarcinoma PancreaticoduodenectomyOncovascular surgeryVascular reconstruction |
| spellingShingle | Jacinta Maria Campos Joana Ferreira José P. Pinto André Marçal Nádia Tenreiro Tiago Castro Fernando Próspero Luís Machado Oncovascular surgery: first two case reports and teamwork perspective Angiologia e Cirurgia Vascular Pancreatic head adenocarcinoma Pancreaticoduodenectomy Oncovascular surgery Vascular reconstruction |
| title | Oncovascular surgery: first two case reports and teamwork perspective |
| title_full | Oncovascular surgery: first two case reports and teamwork perspective |
| title_fullStr | Oncovascular surgery: first two case reports and teamwork perspective |
| title_full_unstemmed | Oncovascular surgery: first two case reports and teamwork perspective |
| title_short | Oncovascular surgery: first two case reports and teamwork perspective |
| title_sort | oncovascular surgery first two case reports and teamwork perspective |
| topic | Pancreatic head adenocarcinoma Pancreaticoduodenectomy Oncovascular surgery Vascular reconstruction |
| url | https://acvjournal.com/index.php/acv/article/view/581 |
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