The use of polytetrafluoroethylene to facilitate the vascular access in recurrent melanoma to limbs

Abstract INTRODUCTION Melanoma with recurrent loco-regional metastases to limbs often makes difficult a second surgical approach because of the adhesions affecting the vascular access. Our aim was to evaluate whether the placement of a polytetrafluoroethylene (PTFE) membrane around vessels might fac...

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Veröffentlicht in:International journal of surgery case reports 2013-01, Vol.4 (1), p.40-43
Hauptverfasser: Ruggeri, Roberta, Camerini, Tiziana, Patuzzo, Roberto, Maurichi, Andrea, Pirovano, Riccardo, Mattavelli, Ilaria, Crippa, Federica, Tolomio, Elena, Moglia, Daniele, Di Florio, Annabella, Santinami, Mario
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container_end_page 43
container_issue 1
container_start_page 40
container_title International journal of surgery case reports
container_volume 4
creator Ruggeri, Roberta
Camerini, Tiziana
Patuzzo, Roberto
Maurichi, Andrea
Pirovano, Riccardo
Mattavelli, Ilaria
Crippa, Federica
Tolomio, Elena
Moglia, Daniele
Di Florio, Annabella
Santinami, Mario
description Abstract INTRODUCTION Melanoma with recurrent loco-regional metastases to limbs often makes difficult a second surgical approach because of the adhesions affecting the vascular access. Our aim was to evaluate whether the placement of a polytetrafluoroethylene (PTFE) membrane around vessels might facilitate a surgical re-approach. PRESENTATION OF CASE We reported a case of a 64-year-old male with a melanoma on the left foot who developed in transit metastases after LND. While performing the inguinopelvic LND we coated the iliac vessels with PTFE patch to facilitate the vascular access in case of re-intervention for a ILP. In the second surgical approach we made a cutaneous incision in the left iliac region and we proceeded through the subcutaneous tissue until detection of iliac vessels, more clearly visible because of the PTFE patch fixed around vascular walls to minimize adhesions. We removed the PTFE coating and easily performed arteriotomy and venotomy for the completion of the ILP. DISCUSSION This case report seems to demonstrate the efficacy of a PTFE membrane applied in a patient around iliac vessels during inguinopelvic dissection, to reduce adhesion density. In fact this membrane provided a barrier to adhesions of the iliac vessels, decreasing the risk of vascular injury thereby facilitating a subsequent vascular access. Re-coating of the iliac vessels with PTFE could be preparatory to a better identification of the vascular structures in cases of a surgical re-approach. CONCLUSION The use of PTFE effectively simplifies the second approach to vessels in event of a melanoma metastasizing to limbs.
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Our aim was to evaluate whether the placement of a polytetrafluoroethylene (PTFE) membrane around vessels might facilitate a surgical re-approach. PRESENTATION OF CASE We reported a case of a 64-year-old male with a melanoma on the left foot who developed in transit metastases after LND. While performing the inguinopelvic LND we coated the iliac vessels with PTFE patch to facilitate the vascular access in case of re-intervention for a ILP. In the second surgical approach we made a cutaneous incision in the left iliac region and we proceeded through the subcutaneous tissue until detection of iliac vessels, more clearly visible because of the PTFE patch fixed around vascular walls to minimize adhesions. We removed the PTFE coating and easily performed arteriotomy and venotomy for the completion of the ILP. DISCUSSION This case report seems to demonstrate the efficacy of a PTFE membrane applied in a patient around iliac vessels during inguinopelvic dissection, to reduce adhesion density. In fact this membrane provided a barrier to adhesions of the iliac vessels, decreasing the risk of vascular injury thereby facilitating a subsequent vascular access. Re-coating of the iliac vessels with PTFE could be preparatory to a better identification of the vascular structures in cases of a surgical re-approach. 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Our aim was to evaluate whether the placement of a polytetrafluoroethylene (PTFE) membrane around vessels might facilitate a surgical re-approach. PRESENTATION OF CASE We reported a case of a 64-year-old male with a melanoma on the left foot who developed in transit metastases after LND. While performing the inguinopelvic LND we coated the iliac vessels with PTFE patch to facilitate the vascular access in case of re-intervention for a ILP. In the second surgical approach we made a cutaneous incision in the left iliac region and we proceeded through the subcutaneous tissue until detection of iliac vessels, more clearly visible because of the PTFE patch fixed around vascular walls to minimize adhesions. We removed the PTFE coating and easily performed arteriotomy and venotomy for the completion of the ILP. DISCUSSION This case report seems to demonstrate the efficacy of a PTFE membrane applied in a patient around iliac vessels during inguinopelvic dissection, to reduce adhesion density. In fact this membrane provided a barrier to adhesions of the iliac vessels, decreasing the risk of vascular injury thereby facilitating a subsequent vascular access. Re-coating of the iliac vessels with PTFE could be preparatory to a better identification of the vascular structures in cases of a surgical re-approach. 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In fact this membrane provided a barrier to adhesions of the iliac vessels, decreasing the risk of vascular injury thereby facilitating a subsequent vascular access. Re-coating of the iliac vessels with PTFE could be preparatory to a better identification of the vascular structures in cases of a surgical re-approach. CONCLUSION The use of PTFE effectively simplifies the second approach to vessels in event of a melanoma metastasizing to limbs.</abstract><cop>Netherlands</cop><pub>Elsevier Ltd</pub><pmid>23108169</pmid><doi>10.1016/j.ijscr.2012.08.013</doi><tpages>4</tpages><oa>free_for_read</oa></addata></record>
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subjects Melanoma
Polytetrafluoroethylene
Surgery
Vessels
title The use of polytetrafluoroethylene to facilitate the vascular access in recurrent melanoma to limbs
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