[Anesthesia in 2 cases of resection of a renal tumor involving the vena cava].
Renal tumors can be associated with a thrombus that affects the renal vein and even the inferior vena cava. Radical surgery may require a 2-phase approach involving different anesthetic techniques: an abdominal approach for removal of the kidney and a thoracic approach for extraction of the thrombus, with extracorporeal circulation and in some cases cessation of blood circulation. We present 2 cases in which nephrectomy and thrombectomy were carried out with the support of extracorporeal circulation. The thrombus was in the renal vein and the inferior vena cava, extending to the outlet to the right atrium in both cases. In 1 case a portion reached the bifurcation of the pulmonary artery. The operation was performed under hypothermia to reduce circulation and did not require aortic clamping, cardioplegia, or cessation of blood flow.
Escudero
A
A
Servicio de Anestesiología y Reanimación, Hospital Universitario Germans Trias i Pujol, Badalona, Barcelona.
Flo
A
A
Espí
C
C
Moret
E
E
Massó
E
E
Cubells
C
C
D000328:Adult; D000769:Anesthesia, Inhalation / Q000379:methods*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D016063:Blood Loss, Surgical; D002292:Carcinoma, Renal Cell / Q000473:pathology / Q000601:surgery*; D003131:Combined Modality Therapy; D003609:Dactinomycin / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D005112:Extracorporeal Circulation; D017809:Fatal Outcome; D005260:Female; D006489:Hemostatic Techniques; D006801:Humans; D007036:Hypothermia, Induced; D007680:Kidney Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000209:etiology; D009361:Neoplasm Invasiveness; D009392:Nephrectomy / Q000379:methods*; D019106:Postoperative Hemorrhage / Q000188:drug therapy; D011655:Pulmonary Embolism / Q000209:etiology; D012082:Renal Veins / Q000473:pathology / Q000601:surgery*; D017131:Thrombectomy / Q000379:methods*; D013927:Thrombosis / Q000209:etiology / Q000601:surgery*; D014682:Vena Cava, Inferior / Q000473:pathology / Q000601:surgery*; D014750:Vincristine / Q000008:administration & dosage; D009396:Wilms Tumor / Q000188:drug therapy / Q000473:pathology / Q000601:surgery*
D003609:Dactinomycin; D014750:Vincristine; D004317:Doxorubicin