title: Complete and safe resection of challenging retroperitoneal tumors: anticipation of multi-organ and major vascular resection and use of adjunct procedures.
abstract: BACKGROUND
  Retroperitoneal tumors are often massive and can involve adjacent organs and/or vital structures, making them difficult to resect. Completeness of resection is within the surgeon's control and critical for long-term survival, particularly for malignant disease. Few studies directly address strategies for complete and safe resection of challenging retroperitoneal tumors.
  
  
  METHODS
  Fifty-six patients representing 63 cases of primary or recurrent retroperitoneal tumor resection between 2004-2009 were identified and a retrospective chart review was performed. Rates of complete resection, use of adjunct procedures, and perioperative complications were recorded.
  
  
  RESULTS
  In 95% of cases, complete resection was achieved. Fifty-eight percent of these cases required en bloc multi-organ resection, and 8% required major vascular resection. Complete resection rates were higher for primary versus recurrent disease. Adjunct procedures (ureteral stents, femoral nerve monitoring, posterior laminotomy, etc.) were used in 54% of cases. Major postoperative complications occurred in 16% of cases, and one patient died (2% mortality).
  
  
  CONCLUSIONS
  Complete resection of challenging retroperitoneal tumors is feasible and can be done safely with important pre- and intraoperative considerations in mind.
authors: Division of Surgical Oncology, University of California at San Francisco, 505 Parnassus Avenue, San Francisco, CA 94143, USA.
authors: William W
authors: WW
authors: Tseng
authors: Sam C
authors: SC
authors: Wang
authors: Charles M
authors: CM
authors: Eichler
authors: Robert S
authors: RS
authors: Warren
authors: Eric K
authors: EK
authors: Nakakura
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000098:blood supply* / Q000473:pathology / Q000601:surgery*; D011183:Postoperative Complications; D012186:Retroperitoneal Neoplasms / Q000098:blood supply* / Q000473:pathology / Q000601:surgery*; D012187:Retroperitoneal Space / Q000098:blood supply* / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult