학술논문

Cavoatrial hypernephroma resection on cardiopulmonary bypass: Mild/normo-versus moderate hypothermia.
Document Type
Article
Source
Perfusion. Nov2023, Vol. 38 Issue 8, p1644-1651. 8p.
Subject
*INFERIOR vena cava surgery
*THROMBOSIS surgery
*RENAL cell carcinoma
*INDUCED hypothermia
*BLOOD-vessel tumors
*HEART tumors
*EXPERIMENTAL design
*SURGICAL blood loss
*INTENSIVE care units
*GLOMERULAR filtration rate
*VENA cava superior
*TIME
*BLOOD transfusion
*METASTASIS
*RETROSPECTIVE studies
*ACQUISITION of data
*SURGERY
*PATIENTS
*TREATMENT duration
*MANN Whitney U Test
*TREATMENT effectiveness
*COMPARATIVE studies
*ARTIFICIAL respiration
*T-test (Statistics)
*MEDICAL records
*DESCRIPTIVE statistics
*KAPLAN-Meier estimator
*CARDIOPULMONARY bypass
*DATA analysis software
*RIGHT heart atrium
*LACTIC acid
*EVALUATION
Language
ISSN
0267-6591
Abstract
Introducion: Renal cell carcinoma (RCC) is one of the most prevalent malignant tumors. It extends up into the systemic veins and right atrium. Surgical extraction of such extensions is usually carried out using cardiopulmonary bypass (CPB) with moderate hypothermic (MH) being frequently applied in order to obtain a clear surgical field. However, due to obvious disadvantages of hypothermia, approaches with mild/normothermia (NT) during CPB have also been established. The current study aims to compare the outcomes of patients undergoing RCC tumor and extensions resection using MH versus NT. Material and Methods: This is a retrospective, non-randomized study. All patients who underwent RCC tumor and extensions resection for stage III or IV (Staehler) RCC in a single center between 2006 and 2020 were included. During surgery, MH or NT were applied. CPB was realized using aortic and bicaval cannulation. We compared the procedural times, transfusion requirements and postoperative outcomes, respectively between the MH and NT groups. Results: A total of 24 consecutive patients (n(NT) = 12, n(MH) = 12) were included in the study (median age NT 68.5 and MH 66.5). The study only showed a significant difference in heart-lung machine times (median CPB time NT 45.5 min and MH 110.0 min, p = 0.004). All other results, loss of drainage, administration of blood products, as well as the postoperative course and mortality were comparable in both groups. Conclusion: The results showed a high perioperative and long-term mortality. The perioperative course was similar after surgery with NT or MH. Therefore, NT which minimizes potential complications of MH should be preferred. [ABSTRACT FROM AUTHOR]