Perioperative anesthetic management for renal cell carcinoma with vena caval thrombus extending into the right atrium: case series.

Autor: Morita Y; Department of Anesthesia, Indiana University School of Medicine, Fesler Hall Room 204, 1130 West Michigan St, Indianapolis, IN, 46202-5115. Electronic address: moritay@iupui.edu., Ayabe K; Cardiac Surgery Intensive Care Unit, Department of Cardiothoracic Surgery, Cedars-Sinai Medical Center Heart Institute, 127 San Vicente Blvd Suite 3100, Los Angeles, CA, 90048., Nurok M; Cardiac Surgery Intensive Care Unit, Department of Cardiothoracic Surgery, Cedars-Sinai Medical Center Heart Institute, 127 San Vicente Blvd Suite 3100, Los Angeles, CA, 90048., Young J; Department of Anesthesia, Indiana University School of Medicine, Fesler Hall Room 204, 1130 West Michigan St, Indianapolis, IN, 46202-5115.
Jazyk: angličtina
Zdroj: Journal of clinical anesthesia [J Clin Anesth] 2017 Feb; Vol. 36, pp. 39-46. Date of Electronic Publication: 2016 Nov 17.
DOI: 10.1016/j.jclinane.2016.09.030
Abstrakt: Renal cell carcinoma has a tendency for vascular invasion and may extend into the inferior vena cava and even into the right-sided cardiac chambers. It has been reported that nephrectomy with thrombectomy can provide immediate palliation of symptoms with 5-year survival rates of up to 72% in the absence of nodal or distant metastasis. The location of the tumor dictates the anesthetic and surgical approach, as extension into the heart often necessitates cardiac surgical involvement. Renal cell carcinoma with vena cava tumor thrombus extending into the right cardiac chamber usually requires cardiopulmonary bypass and occasionally deep hypothermic circulatory arrest for surgical resection, and anesthetic approach should be tailored to each individual case. Thorough preoperative evaluation and the commitment of a multidisciplinary surgery team are indispensable.
(Copyright © 2016 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: