Vascular Surgery Cousulted By Other Departments
Tomohiro Nakajima, Yutaka Iba, Tsuyoshi Shibata, Shingo Tsushima, Ayaka Arihara, Itaru Hosaka, Akihito Ohkawa, Junji Nakazawa, Nobuyoshi Kawaharada.
Sapporo Medical University, Sapporo, Japan.
BACKGROUND: The purpose of this study is to evaluate the results of vascular surgery performed at our hospital, a tertiary emergency general hospital, in patients undergoing surgery in other departments. The results of the study were reviewed.
METHODS: The study included cases in which cardiovascular surgery was performed at the request of other departments over a 15-year period from January 2006 to October 2022. Patient backgrounds, departments that requested surgery, surgical procedures, use of extracorporeal circulation, and surgical techniques were reviewed. Patients with femoral artery exposure or ECMO removal during TAVI requested by cardiology were excluded.
RESULTS: There were 58 vascular surgery cases requested by other departments during the study period. The age was 63±14 years, 43 (74%) were male and 15 (26%) were female. The departments of the patients were urology in 29 (50%), gastroenterology in 18 (31%), orthopedics in 7 (12%), emergency department in 3 (5%), and obstetrics and gynecology in 1 (2%). The following surgical procedures were performed: tumor resection and reconstruction due to tumor invasion of the inferior vena cava in 27 cases (47%), bypass to secure intraperitoneal arterial blood flow in 15 cases (26%), bypass during resection of femoral tumor in 4 cases (7%), hemostasis due to trauma in 3 cases (5%), intraperitoneal hemostasis in 3 cases (5%), thrombectomy in 2 cases (3%), and others in 4 cases (7%). The number of patients who underwent extracorporeal circulation was 4 (7%). Extracorporeal circulation was used in 6 (10%) of the patients. When direct closure of the inferior vena cava could not be achieved, an artificial blood vessel was cut open and used as a patch. In addition, when bypassing to secure intra-abdominal arterial blood flow, we choose inflow to shorten the length of bypass vessels as much as possible.
CONCLUSIONS: We reviewed 15 years of cases of supportive vascular surgery requested by other departments at our hospital. We present the cases and their innovations with video clips.
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