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Effect of utilization of veno-venous bypass vs. cardiopulmonary bypass on complications for high level inferior vena cava tumor thrombectomy and concomitant radical nephrectomy.
- Source :
-
International braz j urol : official journal of the Brazilian Society of Urology [Int Braz J Urol] 2015 Sep-Oct; Vol. 41 (5), pp. 911-9. - Publication Year :
- 2015
-
Abstract
- Purpose: To determine if patients with renal cell carcinoma (RCC) with levels III and IV tumor thrombi are receive any reduction in complication rate utilizing veno-venous bypass (VVB) over cardiopulmonary bypass (CPB) for high level (III/IV) inferior vena cava (IVC) tumor thrombectomy and concomitant radical nephrectomy.<br />Materials and Methods: From May 1990 to August 2011, we reviewed 21 patients that had been treated for RCC with radical nephrectomy and concomitant IVC thrombectomy employing either CPB (n =16) or VVB (n=5). We retrospectively reviewed our study population for complication rates and perioperative characteristics.<br />Results: Our results are reported using the validated Dindo-Clavien Classification system comparing the VVB and CPB cohorts. No significant difference was noted in minor complication rate (60.0% versus 68.7%, P=1.0), major complication rate (40.0% versus 31.3%, P=1.0), or overall complication rate (60.0% versus 62.5%, P=1.0) comparing VVB versus CPB. We also demonstrated a trend towards decreased time on bypass (P=0.09) in the VVB cohort.<br />Conclusion: The use of VVB over CPB provides no decrease in minor, major, or overall complication rate. The use of VVB however, can be employed on an individualized basis with final decision on vascular bypass selection left to the discretion of the surgeon based on specifics of the individual case.
- Subjects :
- Adult
Aged
Aged, 80 and over
Carcinoma, Renal Cell pathology
Cardiopulmonary Bypass methods
Female
Humans
Intraoperative Complications
Kidney Neoplasms pathology
Male
Middle Aged
Nephrectomy methods
Perioperative Period
Postoperative Complications
Retrospective Studies
Statistics, Nonparametric
Thrombectomy methods
Treatment Outcome
Carcinoma, Renal Cell surgery
Cardiopulmonary Bypass adverse effects
Kidney Neoplasms surgery
Nephrectomy adverse effects
Thrombectomy adverse effects
Vena Cava, Inferior surgery
Subjects
Details
- Language :
- English
- ISSN :
- 1677-6119
- Volume :
- 41
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- International braz j urol : official journal of the Brazilian Society of Urology
- Publication Type :
- Academic Journal
- Accession number :
- 26689516
- Full Text :
- https://doi.org/10.1590/S1677-5538.IBJU.2014.0371