O-178 - ONCOVASCULAR SURGERY - THE FORGOTTEN ASPECT OF VASCULAR SURGERY

TOPIC:
Other
AUTHORS:
Lim E. (Christchurch Hospital ~ Christchurch ~ New Zealand) , Lyons O. (Christchurch Hospital ~ Christchurch ~ New Zealand) , Laws P. (Christchurch Hospital ~ Christchurch ~ New Zealand) , Khanafer A. (Christchurch Hospital ~ Christchurch ~ New Zealand)
Introduction:
Oncological surgery is an evolving field in medicine. The aim of surgery for curative intent would mean the resection and reconstruction of blood vessels involved. Therefore, a multidisciplinary approach with the involvement of Vascular surgeons is imperative to achieve this. The advancement of endovascular surgery has overshadowed the importance of open surgical skills that is crucial in achieving complete surgical resection margins and successful vascular reconstruction techniques. We investigated the involvement of the Vascular surgical team in oncological surgery and the outcomes following cancer resection.
Methods:
This is a retrospective study looking at the multidisciplinary approach of oncovascular surgery performed in a single tertiary centre between 1 Jan 2011 - 1 December 2021. Patients were identified from our local electronic surgical audit system and data were extracted from electronic records.
Results:
A total of 66 patients were identified over the study period. The three most common subspecialty collaborations are with colorectal (29%), hepatopancreaticobiliary (26%) and urology (20%). Majority of the consults are done pre-operatively with the involvement of the Vascular surgery team in elective procedures (97%). The role of the Vascular surgeons were dissection (55%) and vascular reconstruction (24%). In the subset of patients who underwent vascular reconstruction, the majority were done as a primary repair (44%) and patch-plasty (10%). 44% of patients did not suffer any perioperative complications following surgery during the admission. Perioperative complications were mainly due to pneumonia (12%) and infection (12%). A 30-day assessment of vascular patency was performed for patients who underwent vascular reconstruction and repair. This showed that the vascular patency rate was 79% in our unit.
Conclusion:
A multidisciplinary approach is common with advanced cancer patients. Our study demonstrates a low postoperative vascular morbidity and mortality. However, the advancement of endovascular surgery has overshadowed the importance of open surgical skills in vascular surgical training. This is particularly important in the involvement of Vascular surgical teams in assisting with oncological procedures for the benefit of patients through collaboration with other surgical specialties.
References:
1) Finlay B, Bednarz J, Dawson J. A multidisciplinary approach to oncological resections with vascular surgeons improves patient outcomes. Eur J Vasc Endovasc Surg. 2020 Aug; 60(2): 293-299. 2) Woo HY, Ahn S, Min S, Han A, Mo H, Ha J, Min SK. Crucial roles of vascular surgeons in oncovascular and non-vascular surgery. Eur J Vasc Endovasc Surg. 2020 Nov; 60(5):764-771 3) Han A, Ahn S, Min SK. Oncovascular surgery: essential roles of vascular surgeons in cancer surgery. Vasc Specialist Int. 2019 Jun; 35(2): 60-69 4) Krutman M, Nishinari K, Pignataro BS, Yazbek G, Bomfim GAZ, Cavalcante RN, et al. Twenty years of experience in vascular reconstructions associated with resection of malignant neoplasms in a single cancer center. J Vasc Surg. 2019 Jun; 69(6): 1880-1888 5) Danczyk RC, Coleman J, Allenswoth J, Azarbal AF, Mitchell EL, Liem TK, et al. Incidence and outcomes of intraoperative vascular surgery consultations. J Vasc Surg. 2015 Jun; 62(1): 177-182
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