Resection of a massive sacrococcygeal teratoma using hypothermic hypoperfusion: a novel use of extracorporeal membrane oxygenation.
A 33-week-gestation infant with a massive sacrococcygeal teratoma weighted 4,000 g, but the actual weight of the infant was approximately 1,500 g. With the potential for massive blood loss and impaired lung compliance during resection, some type of cardiopulmonary support was necessary. Resection was undertaken with the assistance of venoarterial extracorporeal membrane oxygenation (ECMO) and hypothermic hypoperfusion. Immediately after removal of the tumor, which weighted 2,420 g, the infant was decannulated from ECMO, and the carotid artery was primarily reconstructed end-to-end. The amount of intraoperative blood loss was 550 mL Postoperatively, the child weighted 1,580 g. Follow-up head ultrasound results were normal, and the patient has done well. This is the first reported case in which ECMO with hypothermic hypoperfusion was used for resection of a massive tumor. This experience shows that ECMO is both useful and safe as a means of temporary cardiopulmonary support for resection of massive tumors in infants.
Lund
D P
DP
Department of Surgery, Children's Hospital, Boston, MA 02115, USA.
Soriano
S G
SG
Fauza
D
D
Bower
L
L
Jonas
R
R
Hansen
D D
DD
Wilson
J
J
D003050:Coccyx; D015199:Extracorporeal Membrane Oxygenation / Q000379:methods*; D005260:Female; D006801:Humans; D007036:Hypothermia, Induced; D007231:Infant, Newborn; D007234:Infant, Premature; D012447:Sacrum; D013125:Spinal Neoplasms / Q000151:congenital / Q000473:pathology / Q000601:surgery*; D013724:Teratoma / Q000151:congenital / Q000473:pathology / Q000601:surgery*