Surgical resection of a renal cell carcinoma involving the inferior vena cava: the role of the cardiothoracic surgeon

Hdl Handle:
http://hdl.handle.net/10147/116228
Title:
Surgical resection of a renal cell carcinoma involving the inferior vena cava: the role of the cardiothoracic surgeon
Authors:
Parissis, Haralabos; Akbar, Mohammad TAUKEER; Tolan, Michael; Young, Vincent
Citation:
Journal of Cardiothoracic Surgery. 2010 Nov 05;5(1):103
Issue Date:
5-Nov-2010
URI:
http://hdl.handle.net/10147/116228
Abstract:
Abstract Background The techniques for the resection of renal tumors with IVC extension are based on the experience of individual units. We attempt to provide a logical approach of the surgical strategies in a stepwise fashion. Methods Over 6-years 9 patients with renal cell carcinoma invading the IVC, underwent surgery. There were 6 males. The extension was at level IV in 4 and III in 5 cases. CPB used in 8 and hypothermia and circulatory arrest in all patients with level IV disease. The results and an algorithm of the plan of action, as per level of extension are presented. Results Plan of action: For level I-II disease: No Cardiothoracic involvement, For level III: Cardiopulmonary Bypass (CPB) & control of the cavo-atrial junction. For level IV: use of brief periods of Circulatory Arrest & repair of the Cavotomy with a pericardial patch. Postoperative morbidity: prolonged ICU stay, 3 patients (33.3%); tracheostomy, 1 (11.1%); Sepsis, 2 (22.2%); CVA 1, (11.1%). Mortality: 2 patients (22.2%) Conclusions Total clearance of the IVC from an adherent tumor is important, therefore extensive level IV disease presents a surgical challenge. We recommend CPB for level III and brief periods of Total Circulatory Arrest (TCA) for level IV disease.
Item Type:
Journal Article

Full metadata record

DC FieldValue Language
dc.contributor.authorParissis, Haralabos-
dc.contributor.authorAkbar, Mohammad TAUKEER-
dc.contributor.authorTolan, Michael-
dc.contributor.authorYoung, Vincent-
dc.date.accessioned2010-11-24T09:18:00Z-
dc.date.available2010-11-24T09:18:00Z-
dc.date.issued2010-11-05-
dc.identifierhttp://dx.doi.org/10.1186/1749-8090-5-103-
dc.identifier.citationJournal of Cardiothoracic Surgery. 2010 Nov 05;5(1):103-
dc.identifier.urihttp://hdl.handle.net/10147/116228-
dc.description.abstractAbstract Background The techniques for the resection of renal tumors with IVC extension are based on the experience of individual units. We attempt to provide a logical approach of the surgical strategies in a stepwise fashion. Methods Over 6-years 9 patients with renal cell carcinoma invading the IVC, underwent surgery. There were 6 males. The extension was at level IV in 4 and III in 5 cases. CPB used in 8 and hypothermia and circulatory arrest in all patients with level IV disease. The results and an algorithm of the plan of action, as per level of extension are presented. Results Plan of action: For level I-II disease: No Cardiothoracic involvement, For level III: Cardiopulmonary Bypass (CPB) & control of the cavo-atrial junction. For level IV: use of brief periods of Circulatory Arrest & repair of the Cavotomy with a pericardial patch. Postoperative morbidity: prolonged ICU stay, 3 patients (33.3%); tracheostomy, 1 (11.1%); Sepsis, 2 (22.2%); CVA 1, (11.1%). Mortality: 2 patients (22.2%) Conclusions Total clearance of the IVC from an adherent tumor is important, therefore extensive level IV disease presents a surgical challenge. We recommend CPB for level III and brief periods of Total Circulatory Arrest (TCA) for level IV disease.-
dc.titleSurgical resection of a renal cell carcinoma involving the inferior vena cava: the role of the cardiothoracic surgeon-
dc.typeJournal Article-
dc.language.rfc3066en-
dc.rights.holderParissis et al.; licensee BioMed Central Ltd.-
dc.description.statusPeer Reviewed-
dc.date.updated2010-11-23T14:30:38Z-
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