Complete radical nephrectomy and vena caval thrombectomy during circulatory arrest.
case_series · Level IV
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Abstract
PURPOSE: A modification of radical nephrectomy for renal carcinoma and vena caval tumor thrombectomy for supradiaphragmatic tumor extension under hypothermic circulatory arrest is presented. MATERIALS AND METHODS: Nephrectomy was performed during the circulatory arrest time in 16 consecutive patients during the last 4 years. RESULTS: Average hypothermic circulatory arrest time increased by 6 minutes. By elimination of manipulation of tumor and thrombus before circulatory arrest potential thrombus fragmentation and embolization were minimized. There were no significant differences in blood loss or complications compared to a prior series of 10 patients undergoing the procedure using conventional techniques. CONCLUSIONS: Performance of complete radical nephrectomy along with venal caval embolectomy during circulatory arrest increases the safety of the procedure without significant morbidity.