Vascular control for resection of suprahepatic intracaval Wilms' tumor: technical considerations.
J Pediatr Surg
; 35(12): 1836-7, 2000 Dec.
Article
in En
| MEDLINE
| ID: mdl-11101750
ABSTRACT
The surgical resection of Wilms' tumor can be complicated by tumor thrombus extension into the inferior vena cava. In cases of suprahepatic Wilms' tumor thrombus that may extend into the right atrium, a median sternotomy and cardiopulmonary bypass (CPB) are used to facilitate tumor resection. However, if the tumor can be localized and controlled below the atrium, resection without the use of cardiopulmonary bypass may limit morbidity. The authors describe a novel approach to tumor thrombectomy for a Wilms' tumor extending to the suprahepatic vena cava without the use of CPB. The authors used transesophageal echocardiography to localize the tumor thrombus and detect any tumor or air embolization and a minimal lower sternotomy to obtain intrapericardial control of the inferior vena cava. This technique may be useful in selected cases of Wilms' tumor as an alternative to median sternotomy and use of cardiopulmonary bypass.
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Collection:
01-internacional
Database:
MEDLINE
Main subject:
Vena Cava, Inferior
/
Wilms Tumor
/
Kidney Neoplasms
Limits:
Child, preschool
/
Humans
/
Male
Language:
En
Journal:
J Pediatr Surg
Year:
2000
Document type:
Article
Affiliation country:
Estados Unidos