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[Extracorporeal circulation and hypothermy surgery in tumors with vena cava extension: 20 years experience at the University Clinic of Navarra].

Authors :
Rioja Zuazu J
Rodríguez-Rubio Cortadillas F
Zudaire Bergera JJ
Saiz Sansi A
Rosell Costa D
Robles García JE
Rábago G
Berián Polo JM
Source :
Actas urologicas espanolas [Actas Urol Esp] 2008 Apr; Vol. 32 (4), pp. 396-405.
Publication Year :
2008

Abstract

Objective: We present our 20 years experience treating patients with vena cava extension in whom an extracorporeal circulation, hypothermia, cardio circulatory arrest (ECC-H-CCA) in order to perform, together with a tumoral resection, a thrombus resection.<br />Material and Methods: From 1985 to 2005 a total of 28 retroperitoneal tumor were treated: 25 renal cancers, a Wilms tumor, a paratesticular rabdomiosarcoma, and a pheocromocitoma. All of them had an extension by means of thrombus above the suprahepatics veins. All of them were treated by means of ECC-H-CCA for thrombus extraction. A descriptive study of the serie is performed as well as a Kaplan Meyer survival study.<br />Results: Surgical complications were present within 10 patients (35%), with a surgical mortality of two patients (7%): one intra-operatively because a massive embolism of the lungs and the other because of a lung embolism on the 4th post-operative day. Global actuarial survival was 29.1+/-10% at three years and 17.5+/-8% at five years. Analyzing only who do not have metastatic lesions, nor lymph nodes at diagnosis their three year survival was 50.9+/-16.3% and 32.2+/-16% at five years. Mean while those who have any metastatic lesion at diagnosis their three and five years survival was 20.8+/-12% and 10.4+/-9% respectively.<br />Conclusions: The employ of surgical techniques with ECC-H-CCA with in oncological pathology associated with vena cava thrombus is justified and its employment does not worsen the survival; it is indicated because its results, allowing a complete tumoral resection in a safe and reproducible fashion.

Details

Language :
Spanish; Castilian
ISSN :
0210-4806
Volume :
32
Issue :
4
Database :
MEDLINE
Journal :
Actas urologicas espanolas
Publication Type :
Academic Journal
Accession number :
18540260
Full Text :
https://doi.org/10.4321/s0210-48062008000400003