Median patient age was 51 years. Surgery was completed successfully in all patients. Only 1 patient with an adherent intra-atrial thrombus required CPB. Mean blood loss was 450 ml (range 50 to 1,500) except in the patient who required CPB. Postoperative complications occurred in 2 patients. One patient died on the postoperative day 7 of a presumed pulmonary emboli. Pneumothorax and empyema following traumatic line placement developed in the other patient. Nine patients (90%) were free of disease at a median followup of 18 months (range 10 to 84).
Applying transplant techniques in the surgical extirpation of large adrenal masses with or without tumor thrombus affords curative surgery enhanced access and vascular control, and decreases the requirement for venovenous bypass and/or CPB with less morbidity. It also provides acceptable midterm survival and quality of life.
Purchase PDF (582 K) | Surgical treatment of renal cell carcinoma with intrava... Interactive Cardiovascular and Thoracic Surgery |
  Surgical treatment of renal cell carcinoma with intravascular extensionInteractive Cardiovascular and Thoracic Surgery, Volume 3, Issue 2, June 2004, Pages 395-397 Christoph Schimmer, Felix Hillig, Hubertus Riedmiller, Olaf Elert Abstract Long-term survival after surgical treatment is possible in patients with renal cell carcinoma (RCC) extending in the right atrium. Different surgical techniques for the treatment of patients with RCC extending into the vena cava have been advocated, depending on the proximal extent of the tumor. We present and propose an algorithm regarding the operative strategy depending on the extent of tumor growth. |
| Surgical treatment for transvenous tumor extension into... Journal of Vascular Surgery |
 Surgical treatment for transvenous tumor extension into the heart: Four cases, , Journal of Vascular Surgery, Volume 27, Issue 4, April 1998, Pages 740-744 Yoshihiko Tsuji, Chojiro Yamashita, Hidetaka Wakiyama, Yoshiya Toyoda, Masato Yoshida, Takaki Sugimoto, Keiji Ataka, Noboru Ishii, Tsutomu Shida, Masayoshi Okada Abstract From 1984 to 1996, four patients with transvenous intracardiac tumor extension underwent operations in the Kobe University Hospital. The primary tumors of two were intravenous leiomyomatoses originating from the uterus; a third patient had invasive thymoma, and the fourth patient had clear cell sarcoma of the kidney. In 1985, one patient had a curative, staged resection. One-stage operations were carried out in three patients, and all intracardiac tumors were successfully resected en bloc with the primary tumors under conditions of electrical ventricular fibrillation and mild hypothermia. Combined venous reconstructions were necessary for en bloc resection in three cases. Two patients with malignancy received postoperative chemoradiotherapy, and all four patients were discharged uneventfully from our hospital. We consider radical resection with curative intent only for patients with tumors extending into the heart. In these cases, a one-stage operation is preferable, and electrical ventricular fibrillation with mild hypothermia is a recommended method of circulatory assist because of its simplicity. (J Vasc Surg 1998;27:740-4.) PDF (76 K) |
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