[Extracorporeal circulation and hypothermy surgery in tumors with vena cava extension: 20 years experience at the University Clinic of Navarra].
OBJECTIVE
We present our 20 years experience treating patients with vena cava extension in whom an extracorporeal circulation, hypothermia, cardio circulatory arrest (ECC-H-CCA) in order to perform, together with a tumoral resection, a thrombus resection.


METHODS
From 1985 to 2005 a total of 28 retroperitoneal tumor were treated: 25 renal cancers, a Wilms tumor, a paratesticular rabdomiosarcoma, and a pheocromocitoma. All of them had an extension by means of thrombus above the suprahepatics veins. All of them were treated by means of ECC-H-CCA for thrombus extraction. A descriptive study of the serie is performed as well as a Kaplan Meyer survival study.


RESULTS
Surgical complications were present within 10 patients (35%), with a surgical mortality of two patients (7%): one intra-operatively because a massive embolism of the lungs and the other because of a lung embolism on the 4th post-operative day. Global actuarial survival was 29.1+/-10% at three years and 17.5+/-8% at five years. Analyzing only who do not have metastatic lesions, nor lymph nodes at diagnosis their three year survival was 50.9+/-16.3% and 32.2+/-16% at five years. Mean while those who have any metastatic lesion at diagnosis their three and five years survival was 20.8+/-12% and 10.4+/-9% respectively.


CONCLUSIONS
The employ of surgical techniques with ECC-H-CCA with in oncological pathology associated with vena cava thrombus is justified and its employment does not worsen the survival; it is indicated because its results, allowing a complete tumoral resection in a safe and reproducible fashion.
Departamento de Urología, Clínica Universitaria, Universidad de Navarra, Pamplona. jriojazu@gmail.nl
J
J
Rioja Zuazu
F
F
Rodríguez-Rubio Cortadillas
J J
JJ
Zudaire Bergera
A
A
Saiz Sansi
D
D
Rosell Costa
J E
JE
Robles García
G
G
Rábago
J M
JM
Berián Polo
D005112:Extracorporeal Circulation; D006801:Humans; D007036:Hypothermia, Induced; D007680:Kidney Neoplasms / Q000473:pathology / Q000601:surgery*; D009367:Neoplasm Staging; D009360:Neoplastic Cells, Circulating; D013030:Spain; D013997:Time Factors; D014682:Vena Cava, Inferior