Experiences of Tumor Thrombi Removal in the Inferior Vena Cava and the Right Atrium upon Cardiopulmonary Bypass.
10.4326/jjcvs.22.488
- VernacularTitle:下大静脈，右心房内に進展した腫よう血栓に対する体外循環下手術自験４例の検討
- Author:
Takayuki NOMIMURA
;
Kazumasa ORIHASHI
;
Hiroo SHIKATA
;
Taijiro SUEDA
;
Yoshiharu HAMANAKA
;
Yuichiro MATSUURA
- Publication Type:Journal Article
- From:Japanese Journal of Cardiovascular Surgery
1993;22(6):488-492
- CountryJapan
- Language:Japanese
-
Abstract:
Between 1988 and 1992, we experienced 4 cases of removal of renal or hepatic cell carcinoma tumor thrombi extending into the inferior vena cava and the right atrium, under cardiopulmonary bypass. We operated on 3 cases using profound hypothermia and circulatory arrest, and 1 case using moderate hypothermia and the Pringle maneuver. One case developed acute massive pulmonary embolism followed by cardiac arrest during the procedure of freeing the inferior vena cava and died on the second postoperative day due to low output syndrome. The postoperative courses of the other 3 cases were uneventful, and there was no major complication due to surgery. They were discharged and enjoyed normal daily lives. Two cases died due to recurrence of the tumor, 6 and 7 months after the operation, respectively. The merits and demerits of these two surgical methods were discussed. Appropriate selection of these methods and subjects allows safe and complete excision of tumor thrombi with satisfactory operative results.
