Scientific publications

Surgical management of retroperitoneal tumors with vena cava thrombus in the inferior cava using cardiopulmonary bypass, arrested circulation and profound hypothermia

Rodríguez-Rubio FI, Abad JI, Sanz G, Diez-Caballero F, Martín-Marquina A, Rosell D [SP], Robles JE [SP], Llorens R, Berián JM.
Department of Urology, Clinica Universitaria, Faculty of Medicine, University of Navarra, Pamplona, Spain.

Magazine: European Urology

Date: Jan 1, 1997

Urology [SP]

OBJECTIVE
It was our aim to review our surgical experience with retroperitoneal tumors extending to the vena cava by using cardiopulmonary bypass, deep hypothermia and circulatory arrest.

METHOD
We performed this procedure in 15 patients. The ages ranged between 16 and 70 years. The primary malignancies were renal cell carcinoma (n = 13), Wilms' tumor (n = 1) and paratesticular rhabdomyosarcoma (n = 1).

RESULTS
There were no operative deaths. One patient died on the fourth postoperative day because of pulmonary embolization. The most common postoperative complications were: 1 patient required surgical reexploration because of hemorrhage, there was transitory renal failure in 3 patients, 1 patient developed a postoperative reactive psychosis and 1 patient developed a subclinical pericarditis.

CONCLUSION
We believe that the resection of retroperitoneal malignancies with venous tumor thrombus extension offers, in selected patients, the only chance of reasonable long-term survival. The application of a cardiopulmonary bypass and hypothermia in high level vena cava thrombi is an important advance that has improved the safety and technical efficacy of a difficult surgical undertaking.

CITATION  Eur Urol. 1997;32(2):194-7

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