Tumor thrombus in the inferior vena cava (IVC) occurs in 4-10% of patients with renal cell carcinoma (RCC) and poses a challenge for the surgical team. Because there is no systemic therapy available to significantly reduce tumor burden, surgical intervention is the only treatment. However, the surgical approach is associated with significant morbidity and mortality. When the thrombus extends above the diaphragm, the use of cardiopulmonary bypass (CPB) and accompanying deep hypothermic circulatory arrest (DHCA) has usually been advocated. However, complications inherent to CPB and DHCA, such as coagulopathy and central nervous system complications, have led us to search for an alternative surgical approach to these tumors. The purpose of this study is to describe the surgical technique used in five patients with large RCC with tumor thrombus extending into the supradiaphragmatic IVC and Right atrium (RA), Right atrium, who underwent extensive resection without CPB and DHCA.

Surgical treatment of renal carcinoma with atrial tumor thrombus avoiding cardiopulmonary bypass: step-by-step description / Guglielmo, Nicola; Melandro, Fabio; Montalto, GIOACCHINO MARIA; Poli, Luca; DELLA PIETRA, Fatima; Rossi, Massimo; Mazzesi, Giuseppe; Berloco, Pasquale Bartolomeo. - In: UROLOGIA. - ISSN 0391-5603. - 82:4(2015), pp. 223-5-225. [10.5301/uro.5000126]

Surgical treatment of renal carcinoma with atrial tumor thrombus avoiding cardiopulmonary bypass: step-by-step description

GUGLIELMO, NICOLA;MELANDRO, FABIO;MONTALTO, GIOACCHINO MARIA;POLI, Luca;DELLA PIETRA, Fatima;ROSSI, MASSIMO;MAZZESI, Giuseppe;BERLOCO, Pasquale Bartolomeo
2015

Abstract

Tumor thrombus in the inferior vena cava (IVC) occurs in 4-10% of patients with renal cell carcinoma (RCC) and poses a challenge for the surgical team. Because there is no systemic therapy available to significantly reduce tumor burden, surgical intervention is the only treatment. However, the surgical approach is associated with significant morbidity and mortality. When the thrombus extends above the diaphragm, the use of cardiopulmonary bypass (CPB) and accompanying deep hypothermic circulatory arrest (DHCA) has usually been advocated. However, complications inherent to CPB and DHCA, such as coagulopathy and central nervous system complications, have led us to search for an alternative surgical approach to these tumors. The purpose of this study is to describe the surgical technique used in five patients with large RCC with tumor thrombus extending into the supradiaphragmatic IVC and Right atrium (RA), Right atrium, who underwent extensive resection without CPB and DHCA.
2015
01 Pubblicazione su rivista::01a Articolo in rivista
Surgical treatment of renal carcinoma with atrial tumor thrombus avoiding cardiopulmonary bypass: step-by-step description / Guglielmo, Nicola; Melandro, Fabio; Montalto, GIOACCHINO MARIA; Poli, Luca; DELLA PIETRA, Fatima; Rossi, Massimo; Mazzesi, Giuseppe; Berloco, Pasquale Bartolomeo. - In: UROLOGIA. - ISSN 0391-5603. - 82:4(2015), pp. 223-5-225. [10.5301/uro.5000126]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/872323
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