Outcomes of inferior vena cava reconstruction using artificial or autologous materials in ex vivo liver resection and autotransplantation

Background: The use of artificial or autologous materials for inferior vena cava (IVC) reconstruction is controversial. This study retrospectively explored the effects of different materials on perioperative outcomes.Methods: This study included 91 patients who underwent IVC reconstruction during liver auto -transplantation between 2014 and 2020. A univariate analysis was performed to select variables affecting postoperative morbidity. The effect of IVC reconstruction materials on perioperative outcomes was tested with a multivariable generalized linear model. The effects on postoperative morbidity and operation time were further tested with the multivariate regression analysis based on the generalized estimating equation. Adjusted models were used in all analyses.Results: A median operation time of 710 (633-790) min, a median blood loss of 2200 (1550-3000) mL, an incidence of 33% (30/91) for major morbidities and a median comprehensive complication index (CCI) of 0.0 (0.0-26.2) were observed, with no IVC reconstruction-related complications postoperatively or in the long term. The IVC reconstruction material had no significant effect on postoperative outcomes, while artificial materials significantly increased inpatient cost (191 +/- 35 vs. 164 +/- 36 k Yuan, p < 0.001). The multivariate regression revealed a significant shift in outcomes of operation time (p 1/4 0.0368).Discussion: Artificial grafts are recommended for IVC reconstruction if cost is not a factor.(c) 2022 Asian Surgical Association and Taiwan Robotic Surgery Association. Publishing services by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/ licenses/by-nc-nd/4.0/).

Automated summary

This retrospective study examined the effects of different materials on perioperative outcomes in patients undergoing IVC reconstruction. It was found that the choice of IVC reconstruction material did not significantly affect postoperative outcomes, but artificial materials significantly increased inpatient cost.