A venous bypass pump system from the femoral vein to the right atrium offers a feasible surgical approach for resecting renal cell carcinoma with suprahepatic vena caval extension without requiring circulatory arrest.
May allow resection without circulatory arrest in select cases; leaves open need for comparative validation before wider use.
Renal cell carcinoma involves the vena cava in approximately 4% of the patients. Presently surgical extirpation is the only form of therapy that can result in cure. Recently management of extensive vena caval involvement has involved the use of cardiopulmonary bypass with circulatory arrest and hypothermia. We describe a technique using a venous bypass pump system (femoral vein to right atrium) for resection of renal cell carcinoma with suprahepatic vena caval extension (type II), which avoids the risks and complications of cardiac arrest and hypothermia but allows for rapid conversion to total cardiopulmonary bypass should the intraoperative need arise.
No takes yet. Share an insight, caveat, or question.
Janosko et al. (1991) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: