TY - JOUR
T1 - The use of polytetrafluoroethylene to facilitate the vascular access in recurrent melanoma to limbs
AU - Ruggeri, Roberta
AU - Camerini, Tiziana
AU - Patuzzo, Roberto
AU - Maurichi, Andrea
AU - Pirovano, Riccardo
AU - Mattavelli, Ilaria
AU - Crippa, Federica
AU - Tolomio, Elena
AU - Moglia, Daniele
AU - Di Florio, Annabella
AU - Santinami, Mario
PY - 2013
Y1 - 2013
N2 - 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.
AB - 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.
KW - Melanoma
KW - Polytetrafluoroethylene
KW - Surgery
KW - Vessels
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UR - http://www.scopus.com/inward/citedby.url?scp=84867769009&partnerID=8YFLogxK
U2 - 10.1016/j.ijscr.2012.08.013
DO - 10.1016/j.ijscr.2012.08.013
M3 - Article
C2 - 23108169
AN - SCOPUS:84867769009
VL - 4
SP - 40
EP - 43
JO - International Journal of Surgery Case Reports
JF - International Journal of Surgery Case Reports
SN - 2210-2612
IS - 1
ER -