Cavoatrial tumor thrombectomy using cardipulmonary bypass without circulatory arrest

Stewart, James R.; Carey, John A.; McDougal, W. Scott; Merrill, Walter H.; Koch, Michaël; Bender, Harvey W.

doi:10.1016/0003-4975(91)90111-3

Cited by 96 publications

(64 citation statements)

References 13 publications

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“…Although it is becoming safer, the potential risk and complications inherent to CPB and DHCA have been well-documented in detail previously [5,8,10,[24][25][26][27]. Stewart et al [26] encouraged thrombus extraction without CPB and suggested its use only in cases that require vena cava resection or grafting. Nesbitt et al [28] reported good results in 19 patients with RCC associated with vena cava tumour thrombi managed by complete liver mobilization, the Pringle manoeuvre for 2 min to allow liver decompression and complete vena cava control.…”

Section: Discussionmentioning

confidence: 99%

Surgical management of large adrenal tumours: the University of Miami experience using liver transplantation techniques

et al. 2008

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OBJECTIVE To report our experience in the surgical management of patients with large adrenal masses and describe the key steps in performing radical resections, which are especially demanding where thrombi extend into the inferior vena cava (IVC). PATIENTS AND METHODS From 2003 to 2007, 14 patients presented with large adrenal mass, and underwent surgical extirpation. In five patients thrombi extended into the IVC, causing Budd–Chiari syndrome in one. RESULTS The median (range) patient age was 48 (40–58) years. The excision was radical with negative tumour margins in all cases. Cardiopulmonary bypass (CPB) was required in one case with adherent intra‐atrial thrombus. The mean blood loss was 500 (250–1500) mL except in the patient who required CPB. Morbidity included pleural effusion (three patients) and postoperative pneumonia (two), which responded to conservative management. All patients were alive and free of disease at a median follow‐up of 12 (5–42) months. CONCLUSIONS Surgical extirpation of large adrenal masses requires technical experience to optimize outcome. Total tumour excision is the only therapeutic option in such cases and provides acceptable results in survival and quality of life.

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Section: Discussionmentioning

confidence: 99%

Surgical management of large adrenal tumours: the University of Miami experience using liver transplantation techniques

et al. 2008

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“…Введение Единственным эффективным методом лечения больных раком почки с опухолевым венозным тром-бозом является хирургический [1][2][3][4][5][6][7][8][9][10][11]. Нефрэктомия, тромбэктомия при распространении опухоли в ретро-печеночный (тромбоз III уровня) и наддиафрагмальный отделы нижней полой вены (НПВ) (тромбоз IV уров -ня) ассоциированы со значительными техническими сложностями, как правило, выполняются в условиях искусственного кровообращения (ИК) и сопровожда-ются высокой частотой осложнений и летальных ис-ходов [2][3][4].…”

Section: Abstract: Kidney Cancer Venous Tumor Thrombus Thrombectomyunclassified

“…Медиана диаметра опухоли почки составила 11 (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22) см. У всех пациентов имелся опу-холевый венозный тромбоз: у 82 (49,1 %) больных кра-ниальная граница тромба достигала внутрипеченоч-ного отдела НПВ, у 85 (50,9 %) опухолевый тромбоз распространялся выше уровня диафрагмы (в интра-перикардиальный отдел НПВ -у 44 (26,3 %), в правое предсердие (ПП) -у 39 (23,4 %), пролабировал в пра-вый желудочек -у 2 (1,2 %) больных).…”

Section: Abstract: Kidney Cancer Venous Tumor Thrombus Thrombectomyunclassified

Surgical treatment of Renal Cell Carcinoma (RCC) with level III–IV tumor venous thrombosis

Давыдов¹,

Матвеев²,

Волкова³

et al. 2016

Cancer Urology

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“…Two observational studies demonstrated an increased rate of blood loss in patients with a level III or IV caval tumor thrombus, and in whom cardiopulmonary bypass with or without hypothermic arrest was used during the thrombectomy [69,70]. Notably, the use of hypothermia increases the risk of coagulopathy and subsequent bleeding [68].…”

Section: Nephrectomy With Inferior Venous Cava Thrombectomymentioning

confidence: 99%

Blood Loss and Massive Transfusion in Patients Undergoing Major Oncological Surgery: What Do We Know?

Cata

Gottumukkala

2012

ISRN Anesthesiology

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Patients with solid malignancies who were not candidates for tumor resections in the past are now presenting for extensive oncological resections. Cancer patients are at risk for thromboembolic complications due to an underlying hypercoagulable state; however, some patients may have an increased risk for bleeding due to the effects of chemotherapy, the administration of anticoagulant drugs, tumor-related fibrinolysis, tumor location, tumor vascularity, and extent of disease. A common potential complication of all complex oncological surgeries is massive intra-and postoperative hemorrhage and the subsequent risk for massive blood transfusion. This can be anticipated or unexpected. Several surgical and anesthesia interventions including preoperative tumor embolization, major vessel occlusion, hemodynamic manipulation, and perioperative antifibrinolytic therapy have been used to prevent or control blood loss with varying success. The exact incidence of massive blood transfusion in oncological surgery is largely unknown and/or underreported. The current literature mostly consists of purely descriptive observational studies. Thus, recommendation regarding specific perioperative intervention cannot be made at this point, and more research is warranted.

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Cavoatrial tumor thrombectomy using cardipulmonary bypass without circulatory arrest

Cited by 96 publications

References 13 publications

Surgical management of large adrenal tumours: the University of Miami experience using liver transplantation techniques

Surgical management of large adrenal tumours: the University of Miami experience using liver transplantation techniques

Surgical treatment of Renal Cell Carcinoma (RCC) with level III–IV tumor venous thrombosis

Blood Loss and Massive Transfusion in Patients Undergoing Major Oncological Surgery: What Do We Know?

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