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PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
5
pubmed:dateCreated
1991-6-3
pubmed:abstractText
Of 29 patients with inferior vena caval tumor thrombus, 14 with supradiaphragmatic extension were deemed suitable for operation. Patients (age, 7.5 to 70 years) had renal cell carcinoma (n = 8), Wilms' tumor (n = 2), transitional cell carcinoma (n = 1), and adrenal carcinoma (n = 3). Seven patients had stage III disease, and 7 patients had stage IV disease. Two patients (group A) had unresectable disease at exploratory celiotomy, 4 patients (group B) underwent tumor thrombectomy without cardiopulmonary bypass, and cardiopulmonary bypass was employed in 8 patients (group C). Three of 8 group C patients had Budd-Chiari syndrome at diagnosis. Cardiopulmonary bypass with moderate hypothermia, and inferior vena caval interruption (clip or filter), was employed in all patients. There were no perioperative deaths. Transient neurological impairment was observed postoperatively in 2 patients. Coagulopathy developed in 1 patient who had hepatic encephalopathy and Budd-Chiari syndrome preoperatively and in another patient in whom protamine could not be administered. No patient had acute renal failure requiring hemodialysis. Median survival is 41 and 17 months in groups B and C, respectively. Some authors have advocated profound hypothermia and circulatory arrest in these patients. We find that satisfactory visualization and excision can be performed with cardiopulmonary bypass and moderate hypothermia, avoiding potential renal, hepatic, neurological, and septic complications associated with circulatory arrest.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
AIM
pubmed:status
MEDLINE
pubmed:month
May
pubmed:issn
0003-4975
pubmed:author
pubmed:issnType
Print
pubmed:volume
51
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
717-21; discussion 721-2
pubmed:dateRevised
2005-11-17
pubmed:meshHeading
pubmed-meshheading:1850976-Adolescent, pubmed-meshheading:1850976-Adult, pubmed-meshheading:1850976-Aged, pubmed-meshheading:1850976-Blood Transfusion, pubmed-meshheading:1850976-Carcinoma, Renal Cell, pubmed-meshheading:1850976-Carcinoma, Transitional Cell, pubmed-meshheading:1850976-Cardiopulmonary Bypass, pubmed-meshheading:1850976-Child, pubmed-meshheading:1850976-Female, pubmed-meshheading:1850976-Heart Arrest, pubmed-meshheading:1850976-Humans, pubmed-meshheading:1850976-Kidney Neoplasms, pubmed-meshheading:1850976-Length of Stay, pubmed-meshheading:1850976-Male, pubmed-meshheading:1850976-Middle Aged, pubmed-meshheading:1850976-Neoplasm Invasiveness, pubmed-meshheading:1850976-Neoplasm Staging, pubmed-meshheading:1850976-Postoperative Complications, pubmed-meshheading:1850976-Recurrence, pubmed-meshheading:1850976-Survival Rate, pubmed-meshheading:1850976-Thrombosis, pubmed-meshheading:1850976-Vena Cava, Inferior, pubmed-meshheading:1850976-Wilms Tumor
pubmed:year
1991
pubmed:articleTitle
Cavoatrial tumor thrombectomy using cardiopulmonary bypass without circulatory arrest.
pubmed:affiliation
Department of Cardiac and Thoracic Surgery, Vanderbilt University School of Medicine, Nashville, Tennessee.
pubmed:publicationType
Journal Article