Abstract
Objective To explore the surgical treatment of renal cell carcinoma withⅢ,Ⅳtumor thrombus in inferior vena cava(IVC)with or without the aid of cardiopulmonary bypass(CPB). Methods Following the randomized controlled experiment method,the patients were randomly divided into two groups: CPB- assisted surgical treatment of 11 cases,and 11 cases over the same period in accordance with the non-CPB assisted surgery.There were no significant differences in patients'characteristics,including age,gender, side primary tumor stage, tumor size and thrombus levels.Through the statistical analysis of the operation time,estimated blood loss, intraoperative blood transfusions, postoperative hospital stays and perioperative complications, the effects of two surgical procedures were compared. Results Twenty- two cases were operatated successfully, and no intraoperative surgical procedures were converted. The mean operation time [(468.2±45.1)min vs.(440.4±52.5)min],and the mean recovery time after surgery consciousness[(2.5 ±1.6)h vs.(1.5±0.7)h],showed no significant difference between the two groups(P> 0.05).The estimated blood loss[(2 654.6±1 142.3)ml vs.3 751.6±1 072.4)ml], intraoperative blood transfusions [(1 986.2±942.7)ml vs.(3 147.1±997.3)ml], the duration of the drainage[(3.2±1.4) d vs.(4.5± 1.3)d],and postoperative hospital stays[(10.5±1.3) d vs.(12.6±1.9)d]showed significant difference between CPB group and non- CPB group(P<0.05).One case in CPB group had coagulopathy,and after oral administration of warfarin the patient recovered.One case in non- CPB group had liver injury, the treatment was given to protect the liver and the patient recovered.Two cases had postoperative delayed wound healing, regular dressing was given,and the wounds healed. Conclusion CPB- assisted surgery for renal cell carcinoma withⅢ,Ⅳtumor thrombus in IVC had the advantages of less blood loss, less complications and shorter hospital stay over the non- CPB assisted surgery. Key words: Cardiopulmonary bypass; Renal cell carcinoma; Inferior vena cava tumor thrombus; Surgical treatment
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