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August 1974

Vascular Problems in Upper Abdominal Cancer Surgery

Author Affiliations

From the Gastric and Mixed Tumor Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York.

Arch Surg. 1974;109(2):148-153. doi:10.1001/archsurg.1974.01360020010003

Involvement of major vascular structures by a malignant neoplasm frequently militates against performing an adequate cancer operation. Traditionally such involvement is regarded as a contraindication to resection of intra-abdominal cancer. Using modern vascular surgical principles and techniques, it is feasible to resect involved portions of the portal vein, inferior vena cava, celiac axis, and superior mesenteric artery with en bloc extirpation of hepatic, pancreatic, and retroperitoneal tumors. A series of 17 such resections are reported with vascular reconstruction in many instances. All patients had extensive lesions; all but one had undergone exploratory surgery and were regarded as unresectable elsewhere. There were no operative deaths. Five patients died in the early postoperative period of complications. Twelve patients survived more than three months, with eight alive for periods ranging up to 30 months after surgery.