Abstract
PATIENTS PRESENTING FOR resection of renal cell carcinoma with supradiaphragmatic vena cava or right atrial extension offer a host of challenges to both their surgeons and anesthesiologists. The need to perform a complete resection while minimizing the risk of embolization and metastases, which classically calls for median sternotomy and cardiopulmonary bypass (CPB), with or without deep hypothermic circulatory arrest (DHCA), must be balanced against the risks of coagulopathy, bleeding, and neurologic insult often encountered with this approach. Recently, some have advocated sternotomy and CPB-sparing techniques that do not compromise the goal of complete tumor resection. 1 Ciancio G. Shirodkar S.P. Soloway M.S. et al. Renal carcinoma with supradiaphragmatic tumor thrombus: Avoiding sternotomy and cardiopulmonary bypass. Ann Thorac Surg. 2010; 89: 505-510 Abstract Full Text Full Text PDF PubMed Scopus (80) Google Scholar A case of attempted resection of renal cell carcinoma with level III (suprahepatic, supradiaphragmatic, infra-atrial) extension is presented.
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