Vascular reconstruction in children in the oncology center: A case reports

Abstract

In pediatric oncology, tumors with intimate attachment and involvement of major vessels are common and require surgical treatment. However, most surgical procedures do not require resection and vascular reconstruction. In some cases, radical tumor removal is a significant prognostic factor. In such cases, it becomes necessary to reconstruct the affected vessels which cannot be preserved. This creates a complex task for a surgeon, as there is no one-size-fits-all solution and no extensive clinical experience in pediatric oncology. In our clinic, 3 patients requiring inferior vena cava and renal vein reconstruction were treated between 2020 and 2024: a 9-year-old boy (nephroblastoma), a 4-year-old boy (neuroblastoma), and a 10-year-old boy (paraganglioma). Xenopericardium was used as the graft material in the first two cases and allograft was used in the third case. A child with nephroblastoma was followed for 4 years. Blood flow in the inferior vena cava was satisfactory. A boy with neuroblastoma developed thrombosis in the early postoperative period. A patient with a paraganglioma with satisfactory blood flow and a functioning reimplanted kidney was followed for 2 years. This review of clinical cases demonstrates the potential of using various methods of vascular reconstruction and pediatric plastic surgery in the surgical treatment of tumors.

Keywords

vessel reconstruction / xenopericardium / allograft / renal autotransplantation / nephroblastoma / neuroblastoma / paraganglioma / children

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