• F I Rodríguez-Rubio, J I Abad, G Sanz, F Diez-Caballero, A Martín-Marquina, D Rosell, J E Robles, J J Zudaire, R Llorens, and J M Berián.
• Department of Urology, Clinica Universitaria, Faculty of Medicine, University of Navarra, Pamplona, Spain.
• Eur. Urol. 1997 Jan 1;32(2):194-7.

ObjectiveIt was our aim to review our surgical experience with retroperitoneal tumors extending to the vena cava by using cardiopulmonary bypass, deep hypothermia and circulatory arrest.MethodWe performed this procedure in 15 patients. The ages ranged between 16 and 70 years. The primary malignancies were renal cell carcinoma (n = 13), Wilms' tumor (n = 1) and paratesticular rhabdomyosarcoma (n = 1).ResultsThere were no operative deaths. One patient died on the fourth postoperative day because of pulmonary embolization. The most common postoperative complications were: 1 patient required surgical reexploration because of hemorrhage, there was transitory renal failure in 3 patients, 1 patient developed a postoperative reactive psychosis and 1 patient developed a subclinical pericarditis.ConclusionWe believe that the resection of retroperitoneal malignancies with venous tumor thrombus extension offers, in selected patients, the only chance of reasonable long-term survival. The application of a cardiopulmonary bypass and hypothermia in high level vena cava thrombi is an important advance that has improved the safety and technical efficacy of a difficult surgical undertaking.

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