A team of UC Davis surgeons, led by Christopher Evans, professor and chair of the Department of Urologic Surgery, has published a paper that describes a novel way to remove complex testicular tumors. Other UC Davis Health contributors include Victor Rodriguez, clinical professor of cardiac and vascular surgery and director of the Aortic Center, and Richard Bold, professor and chief of the Division of Surgical Oncology. The paper’s first author is Gregory Amend, chief resident in the Department of Urologic Surgery.
The paper, which appears in European Urology Oncology and is featured on the journal’s cover, describes the technique, which was developed to make these surgeries safer. Testicular cancer often spreads to the abdomen and encases the aorta and inferior vena cava, the major blood vessels in the body. Removing these tumors is complex, with significant risk of bleeding. In some cases, patients require replacement of the vena cava, or aorta.
The new approach involves placement of endovascular stents into the aorta and/or vena cava the day before surgery. This is done to bridge the part of the vessel affected by the tumor. These stents are normally used for vascular disease and not for abdominal cancer surgery. The stents help maintain the integrity of the vessels and allow for the tumors to be removed more rapidly and the vessel walls to be resected, as needed.
“I’ve been working with Dr. Bold to remove these complex tumors for 20 years without stents,” Evans said. “This new technique makes the operation lower risk for major intraoperative events.”
Rodriguez, a vascular surgeon, first suggested the idea for a patient who would have required aortic replacement. The paper reports five patient cases completed in the past two years.
Evans initially presented the work at the Philippine Society of Urologic Oncology meeting in September 2019.