Deep hypothermia and XXXX in the surgical management of @entity703 with cavoatrial extension.

@entity1 @entity788 @entity28 @entity1353 @entity5 @entity4 @entity1358 @entity1576 @entity1167 @entity811 @entity204 @entity703
BACKGROUND: The inferior vena cava (IVC) is involved in almost 5% to 10% of @entity703 . Their intraluminar extension to the cardiac cavities occurs with a @entity5 formation at a percentage of 1%. The aim of this study is to present the principles of "radical" management that should be targeted to excision of the kidney together with the @entity5 . MATERIAL: From 2003 through 2008, we treated six @entity1 with @entity1358 involving the IVC and/or the right cardiac chambers. The main symptoms leading to the diagnosis were @entity811 , @entity1353 , or lower limb @entity4 . The extension of the @entity5 was type IV in three cases, type III in two, and type II in one case. METHOD: Extracorporeal circulation combined with a short period of hypothermic @entity1167 was the method used. Radical nephrectomy combined with cavotomy and atriotomy was performed to an "en-block" extirpation of the @entity5 and allowed oncologic surgical clearance of the disease. RESULTS: There was no operative @entity204 . The mean postoperative course duration was 11 days, apart from one @entity28 @entity1 who presented postoperative @entity788 and died on the 44th postoperative day due to @entity1576 . During the cumulative postoperative follow-up of 171 months the @entity1 remain free of recurrence. CONCLUSIONS: The use of extracorporeal circulation and deep hypothermic @entity1167 provides a good method for radical excision of @entity703 involving the IVC with satisfactory morbidity and long-term survival results. Cooperation of urologists and cardiac surgeons is necessary for this type of operation.
