Cardiopulmonary bypass and renal cell carcinoma with level IV tumour thrombus: can deep hypothermic circulatory arrest limit perioperative mortality?

BJU International
Brian ShuchMichael L Blute

Abstract

• To review experience with nephrectomy/thrombectomy for a renal cell carcimoma (RCC) with a level IV tumour thrombus and to evaluate the benefit of deep hypothermic circulatory arrest (DHCA) with cardiopulmonary bypass (CPBP). • A multi-institutional retrospective database was created to assess the outcomes of surgery for RCC and associated level IV tumour thrombus from 1983 to 2007. Patients were identified based on radiographic records/operative findings. • Only cases using CPBP were analysed. Clinicopathological and operative characteristics including use of DHCA were recorded. • Overall survival (OS) for all patients and by use of DHCA was assessed. Comparisons of clinical and operative characteristics by use of DHCA were performed. • A Cox regression model determined predictors of perioperative/in-hospital mortality. • In all, 63 patients underwent resection with CPBP; overall perioperative mortality was 22.2%. • There were no significant differences in clinicopathological characteristics, operative duration, estimated blood loss, transfusions, and hospital stay by use of DHCA. • Perioperative mortality rate was lower in patients undergoing DHCA (8.3% vs 37.5%, P = 0.006). • The median OS was longer for the patients under...Continue Reading

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Citations

Apr 1, 2014·Current Urology Reports·Juan I Martínez-SalamancaJohn A Libertino
Apr 23, 2014·World Journal of Urology·Nnenaya Agochukwu, Brian Shuch
Feb 3, 2016·The Annals of Thoracic Surgery·Mario GaudinoLeonard N Girardi
Sep 21, 2013·Journal of Cardiothoracic and Vascular Anesthesia·Kyota FukazawaGaetano Ciancio
Apr 30, 2013·The Annals of Thoracic Surgery·Jean-Noel FabianiPaul Achouh
Apr 11, 2015·The Journal of Urology·Inderbir S GillMichele Gallucci
May 14, 2016·The Annals of Thoracic Surgery·Christopher LauLeonard N Girardi
Dec 23, 2015·International Braz J Urol : Official Journal of the Brazilian Society of Urology·Ross M SimonPhilippe E Spiess
Apr 2, 2016·Therapeutic Advances in Urology·Leonardo D BorregalesJose A Karam
Dec 21, 2012·Expert Review of Anticancer Therapy·Marc-Olivier TimsitBernard Escudier
May 31, 2019·Clinical & Translational Oncology : Official Publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico·T AssiJ Kattan
Nov 26, 2011·Expert Review of Anticancer Therapy·Srinivas VourgantiGennady Bratslavsky
Jun 23, 2021·International Journal of Urology : Official Journal of the Japanese Urological Association·Yudai IshiyamaKazunari Tanabe

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