Journal «Angiology and Vascular Surgery» • 

2000 • VOLUME 6 • №3

GRAFTING OF THE GREAT VESSELS IN EXTIRPATION OF SOFT TISANE TUMORS OF THE LOWER EXTREMITIES

S.P. Zotov, A.A. Fokin, B.A. Zhevlakov

From March 1987 to January 1999, forty-one reconstructive operations an femoral vessels were performed in 32 patienta undergoing extirpation of soft tissue tumors of the lower extremities closely linked with the great vessels. There were 23 women and 9 men aged 12 to 74 years (mean age 43 years) According to the histological analysis, 30 (94%) patients had malignant tumors. The tumors were mainly located on the anterointemal surface of the femur, namely in the upper third (nine cases), in the middle third (21 cases), and in the lower third of the femur (two cases). Eight patients were found to have the signs of arterial or venous insufficiency in the Involved extremity. Doppler ultrasound, aortoarteriography, distal and retrograde phlebography of the involved extremities were used to specify the size of the tumors (it was from 5 to 15 cm in six and greater than 15 cm in 2e patients) and to demonstrate their interrelation with femoral vessels. In extirpation of neoplasms, the suture was applied to the involved portion of the femoral artery in three cases. Marginal resection of the vessel with a lateral suture or patch graft was performed in twelve patients. Circular resection of the vessel with direct anastomosis of its ends or grafting was attempted in 26 patients. The greater saphenous vein harvested from thecon-tralateral extremity (twelve cases) or a segment of the superficial femoral vein (six cases) were used as plastic materials. After resection of femoral vessels in one piece with tumor nine patients underwent one stage grafting of the artery and vein. Despite thee use in the postoperative time of pneumatic compression of the operated extremity three patients developed thrombosis after femoral vein grafting. Of these, two patients developed thrombosis after marginal resection and mural suture of the reconstructed vessel, which subsequently compelled us to give up application of this technique. The hospital lethality gave 6.6±3.2%, the 3- and 5-year survival was equal to 80.0±6.9% and 63.3±7.7%, respectively. Five patients had turner recurrence which mandated extremity amputation.

KEY WORDS: soft tissue tumors, grafting of great vessels.

P. 48-54

« Back

Angiologia.ru - portal for professionals
VLAANT
Lancet
HI-TECHNOLOGY MEDICINE