Vascular Interventions in Oncovascular Surgery: A Retrospective Analysis of Outcomes and Patency Rates at a Tertiary Center

Purpose: Vascular reconstruction plays a critical role in optimizing oncologic outcomes in tumors involving major vascular structures. Despite its growing importance, comprehensive data on the types of vascular procedures, graft materials utilized, long-term patency, and recurrence rates in oncovascular surgery remain limited. This study aims to evaluate the vascular interventions performed during oncologic resections, assess postoperative outcomes, and analyze graft patency rates in a tertiary care setting. Methods: We conducted a retrospective review of patients who underwent surgical resection for complex abdominal tumors with concurrent vascular reconstruction between January 2023 to April 2024 at our hospital. Data was collected on patient demographics, tumor type, vascular involvement, type of vascular intervention, type of graft used. Primary end points included morbidity, 30 day and 1 year mortality and primary patency of the vessel till 1 year. Secondary end points included vascular reintervention and tumor recurrence. Results: A total of 24 patients(mean age 52.75 years; 87.5% male) were included. Most common tumor pathology was periampullary carcinoma and pancreatic cancer(20.83%) and retroperitoneal leiomyosarcoma(16.66%). Vascular involvement included portal and superior mesenteric veins(25%) and inferior venacava(16.66%). Intervention techniques included grafting[great saphenous vein(20%), polytetrafluroethylene(60%), Bovine pericardium(20%)] and primary repair(58.33%). Graft patency was 100% at 30 days and 87.5% at 1 year. 100% R0 resection was achieved. The overall morbidity was 8.33%, with 4.16% 30-day and 8.33% 1 year mortality. No vascular reintervention was done. Tumor recurrence was noted in 1 patient(4.16%) Conclusion: Vascular reconstructions performed during oncovascular surgery are feasible and safe, with acceptable morbidity, favourable short to mid-term graft patency and low recurrence rates. The involvement of vascular surgeon as part of multidisciplinary team in preoperative planning is crucial for facilitating complete oncologic clearance in complex abdominal tumors involving vascular structures.