Reconstructive vascular surgery in pediatric oncology: literature review

   Background. In some rare cases pediatric solid tumors may infiltrate or incase major vessels, which may require vascular plastics as part of radical tumor resection. As these situations are rare in pediatric surgeon practice, there is no common approach to this problem. In order to analyze the available experience we reviewed published cases concerning vascular plastics in pediatric oncosurgery.
   Materials and methods. The references from MEDLINE (PubMed), HighWire Press, and eLibrary electronic databases were analyzed for references describing practical vascular surgery experience with vascular implants published in 2002–2022.
   Results. There is few published data on major vessels reconstruction in patients with pediatric solid tumors. Most publications describe single cases or small case series. The vascular plastics in these children is difficult due to small vessel diameter, difficulties in choosing the right graft, risk of thrombosis, and the need to provide adequate circulation in a rapidly growing child. As there are no major studies of this subject we still have no consensus on optimal vascular reconstruction tactics in children with solid tumors. Therefore, new systematic studies are needed.
   Conclusion. We provide a brief review on currently used methods of vascular plastics and reconstruction available for use in children with solid tumors.

1. Gurgenidze N. N., Shvetsov A. N., Zaytseva A. N., Trushin A. A., Kazantsev I. V., Gevorgyan A. G., Ananyev A. N., Zakharenko A. A., Punanov Yu. A., Kulagin A. D., Zubarovskaya L. S. A radical tumor resection and vascular plastic with xenopericardium as part of complex therapy in a patient with second relapse of nephroblastoma. Case report and literature review. Rossiyskiy zhurnal detskoy gematologii i onkologii = Russian Journal of Pediatric Hematology and Oncology. 2021; 8 (2): 117–22. (In Russ.)

2. Etkin Y., Foley P. J., Wang G. J., Guzzo T. J., Roses R. E., Fraker D. L., Drebin J. A., Jackson B. M. Successful venous repair and reconstruction for oncologic resections. J Vasc Surg Venous Lymphat Disord. 2016; 4 (1): 57–63. doi: 10.1016/j.jvsv.2015.05.003.

3. Ito F., Watanabe Y., Harada T., Ando H., Seo T., Kaneko K., Ishiguro Y., Sakurai T. Combined resection of abdominal aorta and inferior vena cava for retroperitoneal rhabdomyosarcoma invading the aortoiliac bifurcation. J Pediatr Surg. 1998; 33 (10): 1566–8. doi: 10.1016/s0022-3468(98)90501-2.

4. Mavroudis C., Jonas R. A., Bove E. L. Personal glimpses into the evolution of truncus arteriosus repair. World J Pediatr Congenit Heart Surg. 2015; 6 (2): 226–38. doi: 10.1177/2150135115572375.

5. Paran T. S., Corbally M. T., Gross-Rom E., Rutigliano D. N., Kayton M. L., La Quaglia M.P. Experience with aortic grafting during excision of large abdominal neuroblastomas in children. J Pediatr Surg. 2008; 43 (2): 335–40. doi: 10.1016/j.jpedsurg.2007.10.045.

6. Szymczak M., Kaliciński P. J., Kowalewski G., Ciopiński M., Markiewicz-Kijewska M., Broniszczak D., Dembowska-Bagińska B., Kościesza A., Brzezińska-Rajszys G., Patkowski W., Stefanowicz M. Inferior Vena Cava and Venous Outfl ow Reconstruction in Living Donor Liver Transplantation in Children: A Single-Center Retrospective Study and Literature Review. Ann Transplant. 2021; 26: e926217. doi: 10.12659/AOT.926217.

7. Psutka S. P., Leibovich B. C. Management of inferior vena cava tumor thrombus in locally advanced renal cell carcinoma. Ther Adv Urol. 2015; 7 (4): 216–29. doi: 10.1177/1756287215576443.

8. Cox S. G., Davidson A., Thomas J., Brooks A., Hewitson J., Numanoglu A., Millar A. J. W. Surgical management and outcomes of 12 cases of Wilms tumour with intracardiac extension from a single centre. Pediatr Surg Int. 2018; 34 (2): 227–35. doi: 10.1007/s00383-017-4197-x.

9. Lalla A., Pritchard-Jonesb K., Walkerc J., Huttond C., Stevensd S., Azmye A., Carachi R. Wilms’ tumor with intracaval thrombus in the UK Children’s Cancer Study Group UKW3 trial. J Pediatr Surg. 2006; 41 (2): 382–7. doi: 10.1016/j.jpedsurg.2005.11.016.

10. Grimaldi C., Bertocchini A., Crocoli A., de Ville de Goyet J., Castellano A., Serra A., Spada M., Inserra A. Caval replacement strategy in pediatric retroperitoneal tumors encasing the vena cava: a single-center experience and review of literature. J Pediatr Surg. 2019; 54 (3): 557–61. doi: 10.1016/j.jpedsurg.2018.06.008.

11. Vlahova A., Konstantinov G., Antonova Z., Pahnev Y., Oparanova V., Kartulev N., Shivachev H. 9-Month-Old Girl with Thoracic Neuroblastoma Encasing the Subclavian Artery, a Case Report. Am J Biomed Sci Res. 2021; 14 (4). AJBSR.MS.ID.002017. doi: 10.34297/AJBSR.2021.14.002017.

12. Koltuksuz U., Gürsoy M. H., Aydinç M., Ozgen U., Ege E., Mutus M. Injuries of large vessels in high stage neuroblastoma surgery. A case report. J Cardiovasc Surg (Torino). 1999; 40 (5): 711–3. PMID: 10597009.

13. Chong D. S. T., Constantinou J., Davis M., Hamilton G. Calcification of a Synthetic Renovascular Graft in a Child. EJVES Short Rep. 2016; 33: 13–5. doi: 10.1016/j.ejvssr.2016.06.001.

14. Tian W., Fei Y., Liu Z. L., Yao J. Standard resection procedure can increase the complete resection rate in pediatric patients with locally advanced abdominal neuroblastoma. Transl Cancer Res. 2016; 5 (5): 607–12 doi: 10.21037/tcr.2016.10.53.

15. Kaprin A. D., Ryabov A. B., Khomyakov V. M., Cheremisov V. V., Khoronenko V. E., Chissov V. I., Volchenko N. N., Kolobaev I. V., Chaika A. V., Trunov D. O., Ivanov A. V., Kostrygin A. K., Pugaev D. M., Stetsyuk A. N. Resection of the inferior vena cava in locally advanced non-organ retroperitoneal tumors. Onkologiya. Zhurnal imeni P. A. Gertsena = P. A. Herzen Journal of Oncology. 2017; 6 (1): 28–38. (In Russ.)

16. Sutton E. J., Tong R. T., Gillis A. M., Henning T. D., Weinberg V. A., Boddington S., Haas-Kogan D. A., Matthay K., Sha V., Gooding C., Coakley F. V., Daldrup-Link H. Decreased aortic growth and middle aortic syndrome in patients with neuroblastoma after radiation therapy. Pediatr Radiol. 2009; 39: 1194–202. doi: 10.1007/s00247-009-1351-1.

17. Luehr M., Siepe M., Beyersdorf F., Schlensak C. Extra-anatomic bypass for recurrent abdominal aortic and renal in-stent stenoses following radiotherapy for neuroblastoma. Interact Cardiovasc Thorac Surg 2009; 8 (4): 488–90. doi: 10.1510/icvts.2008.195230.

18. Szavay P., Luithle T., Semler O., Graf N., Fuchs J. Surgery of cavoatrial tumor thrombus in nephroblastoma: a report of the SIOP / GPOH study. Pediatr Blood Cancer. 2004; 43 (1): 40–5. doi: 10.1002/pbc.20056

19. Akhaladze D. G., Shatalov K. V., Arnautova I. V., Merkulov N. N., Kachanov D. Yu., Zarginava G. G., Krivonosov A. A., Miakova N. V. Inferior vena cava and right atrial thrombosis in children with embryonal tumors. Pediatric Hematology / Oncology and Immunopathology. 2021; 20 (3): 108–15. (In Russ.)

20. Murthi G., Kocvildirim E., Sellathury S., Cuckow P. M., Wilcox D. T., Michalski A., Sebire N. J., Elliott M. J., Duffy P. G. Wilms’ tumor with persistent intravascular extension: a review of the surgical aspects of management. J Pediatr Urol. 2006; 2 (5): 439–45. doi: 10.1016/j.jpurol.2005.10.004.

21. Orbach L., Nachmany I., Goykhman Y., Lahat G., Yossepowitch O., Beri A., Ben-Gal Y., Klausner J. M., Lubezky N. Surgical Approach to Abdominal Tumors Involving the Inferior Vena Cava. Isr Med Assoc J. 2020; 22 (6): 364–8. PMID: 32558442.

22. Shamberger R., Ritchey M., Haase G., Bergemann T., Loechelt-Yoshioka T., Breslow N., Green D. Intravascular Extension of Wilms Tumor. Ann Surg. 2001; 234 (1): 116–21. doi: 10.1097/00000658-200107000-00017.

23. Stanley J. C., Zelenock G. B., Messina L. M., Wakefield T. W. Pediatric renovascular hypertension: a thirty-year experience of operative treatment. J Vasc Surg. 1995; 21 (2): 212–26; discussion 226–7. doi: 10.1016/s0741-5214(95)70263-6.

24. Min S. K., Cho S., Kim H. Y., Kim S. J. Pediatric Vascular Surgery Review with a 30-Year-Experience in a Tertiary Referral Center. Vasc Specialist Int. 2017; 33 (2): 47–54. doi: 10.5758/vsi.2017.33.2.47.

25. Sarti L. Total prosthetic transplantation of the inferior vena cava, with venous drainage restoration of the one remaining kidney on the graft, successfully performed on a child with Wilms’ tumor. Surgery. 1970; 67 (5): 851–5. PMID: 4315277.

26. Ribeiro R. C., Schettini S. T., de Campos V., Abib S., de Fonseca J. H. P., Cypriano M., da Silva N. S. Cavectomy for the treatment of Wilms tumor with vascular extension. J Urol. 2006; 176 (1): 279–83. doi: 10.1016/S0022-5347(06)00561-1.

27. Angelico R., Passariello A., Pilato M., Cozzolino T., Piazza M., Miraglia R., D’Angelo P., Capasso M., Saffioti M. C., Alberti D., Spada M. Ante situm liver resection with inferior vena cava replacement under hypothermic cardiopolmunary bypass for hepatoblastoma: Report of a case and review of the literature. Int J Surg Case Rep. 2017; 37: 90–6. doi: 10.1016/j.ijscr.2017.06.008.

28. Hort A., Karpelowsky J., Shun A., Thomas G. Use of a donor iliac vein graft for reconstruction of the inferior vena cava in liver transplantation for hepatoblastoma with caval extension. Pediatr Transplant. 2019; 23 (4): e13409. doi: 10.1111/petr.13409.

29. Fuchs J., Cavdar S., Blumenstock G., Ebinger M., Schäfer J. F., Sipos B., Warmann S. W. POST-TEXT III and IV Hepatoblastoma: Extended Hepatic Resection Avoids Liver Transplantation in Selected Cases. Ann Surg. 2017; 266 (2): 318–23. doi: 10.1097/SLA.0000000000001936.

30. Chardot C., Saint Martin C., Gilles A., Brichard B., Janssen M., Sokal E., Clapuyt P., Lerut J., Reding R., Otte J. B. Living-related liver transplantation and vena cava reconstruction after total hepatectomy including the vena cava for hepatoblastoma. Transplantation. 2002; 73 (1): 90–2. doi: 10.1097/00007890-200201150-00017.

31. Baxter B. T., Mahoney C., Johnson P. J., Selmer K. M., Pipinos I. I., Rose J., Neff J. R. Concomitant arterial and venous reconstruction with resection of lower extremity sarcomas. Ann Vasc Surg. 2007; 21 (3): 272–9. doi: 10.1016/j.avsg.2007.03.005.

32. Qureshi S. S., Suresh M., Dhareshwar J., Smriti V. Limb sparing surgery with vascular reconstruction for nonrhabdomyosarcoma soft tissue sarcoma in infants: A novel solution using allogenic vein graft from the parent. J Pediatr Surg. 2020; 55 (8): 1673–6. doi: 10.1016/j.jpedsurg.2020.03.029.