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Effect of utilization of veno-venous bypass vs. cardiopulmonary bypass on complications for high level inferior vena cava tumor thrombectomy and concomitant radical nephrectomy
Simon, Ross M.; Kim, Timothy; Espiritu, Patrick; Kurian, Tony; Sexton, Wade J.; Pow-Sang, Julio M.; Sverrisson, Einar; Spiess, Philippe E..
  • Simon, Ross M.; University of South Florida. Department of Urology. Tampa. US
  • Kim, Timothy; University of South Florida. Department of Urology. Tampa. US
  • Espiritu, Patrick; University of South Florida. Department of Urology. Tampa. US
  • Kurian, Tony; University of South Florida. Department of Urology. Tampa. US
  • Sexton, Wade J.; University of South Florida. Department of Urology. Tampa. US
  • Pow-Sang, Julio M.; University of South Florida. Department of Urology. Tampa. US
  • Sverrisson, Einar; University of South Florida. Department of Urology. Tampa. US
  • Spiess, Philippe E.; University of South Florida. Department of Urology. Tampa. US
Int. braz. j. urol ; 41(5): 911-919, Sept.-Oct. 2015. tab, graf
Article in English | LILACS | ID: lil-767039
ABSTRACT
ABSTRACT

Purpose:

To determine if patients with renal cell carcinoma (RCC) with levels III and IV tumor thrombi are receive any reduction in complication rate utilizing veno-venous bypass (VVB) over cardiopulmonary bypass (CPB) for high level (III/IV) inferior vena cava (IVC) tumor thrombectomy and concomitant radical nephrectomy. Materials and

Methods:

From May 1990 to August 2011, we reviewed 21 patients that had been treated for RCC with radical nephrectomy and concomitant IVC thrombectomy employing either CPB (n =16) or VVB (n=5). We retrospectively reviewed our study population for complication rates and perioperative characteristics.

Results:

Our results are reported using the validated Dindo-Clavien Classification system comparing the VVB and CPB cohorts. No significant difference was noted in minor complication rate (60.0% versus 68.7%, P=1.0), major complication rate (40.0% versus 31.3%, P=1.0), or overall complication rate (60.0% versus 62.5%, P=1.0) comparing VVB versus CPB. We also demonstrated a trend towards decreased time on bypass (P=0.09) in the VVB cohort.

Conclusion:

The use of VVB over CPB provides no decrease in minor, major, or overall complication rate. The use of VVB however, can be employed on an individualized basis with final decision on vascular bypass selection left to the discretion of the surgeon based on specifics of the individual case.
Subject(s)


Full text: Available Index: LILACS (Americas) Main subject: Vena Cava, Inferior / Carcinoma, Renal Cell / Cardiopulmonary Bypass / Thrombectomy / Kidney Neoplasms / Nephrectomy Type of study: Observational study / Prognostic study Limits: Adult / Aged / Aged80 / Female / Humans / Male Language: English Journal: Int. braz. j. urol Journal subject: Urology Year: 2015 Type: Article Affiliation country: United States Institution/Affiliation country: University of South Florida/US

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Full text: Available Index: LILACS (Americas) Main subject: Vena Cava, Inferior / Carcinoma, Renal Cell / Cardiopulmonary Bypass / Thrombectomy / Kidney Neoplasms / Nephrectomy Type of study: Observational study / Prognostic study Limits: Adult / Aged / Aged80 / Female / Humans / Male Language: English Journal: Int. braz. j. urol Journal subject: Urology Year: 2015 Type: Article Affiliation country: United States Institution/Affiliation country: University of South Florida/US