SAĞ ATRİUMA UZANIM GÖSTEREN RENAL TÜMÖRLERDE İNFRARENAL VENA KAVA İNFERİOR KANULASYONU – HİPOTERMİK DOLAŞIM DURDURULMASINI ENGELLEYEN YÖNTEM

Abstract

<div><!--block-->Objective: Vena cava thrombectomy together with radical tumor excision in the case of cavoatrial tumor thrombosis is vitally important. In this document, we present the infrarenal inferior vena cava cannulation technique which overcomes the need of total circulatory arrest during the treatment of renal tumors extending into the right atrium.&nbsp;<br><br>Methods: Between June 2013 and December 2017, 5 patients with renal tumors extending into the right atrium, were diagnosed. The mean age of the patients was 43.2 years. One pediatric and 1 adult patient were male, the other 3 were adult females. The three-venous cannulation system containing vena cava superior, infrarenal vena cava inferior and two-stage venous cannulae was used. The tumor thrombus was removed following vena cava superior and infrarenal vena cava inferior cannulations. A two-stage venous cannula was placed in the right atrium while closing atriotomy. The procedure was continued.&nbsp;<br><br>Results: There was no mortality in the peroperative and postroperative period. The mean operation time was 465 minutes, the duration of cardiopulmonary bypass was 48 minutes and myocardial ischemia time was 27 minutes. The mean hepatic and renal ischemia time was 15.4 minutes. The mean intensive care unit and hospital stay were 28.4 hours and 9.3 days, respectively. The total follow-up period was 12 months. There was no mortality in long term follow-up.&nbsp;<br><br>Conclusion: Complete tumor resection without any remnant is the main predictor of mortality in this particular patient population. This technique allows tumor resection in moderate hypothermia without needing hypothermic circulation and provides a safe procedure for complete resection.&nbsp;</div>