HYPOTHERMIA AND CIRCULATORY ARREST IN THE SURGICAL-MANAGEMENT OF RENAL-CELL CARCINOMA WITH VENA-CAVAL INVOLVEMENT

Six patients operated on for renal cell carcinoma with vena caval invo lvement were prospectively studied. The mean age of the four men and t wo women was 58 (range 51-77) years. In four of them the tumour was ex cised during cardiopulmonary bypass and deep hypothermic circulatory a rrest. The operation was radical in three of these patients and pallia tive in one. There were no major complications or deaths during hospit alisation averaging 9 (7-17) days. The mean follow-up was 9 (4-14) mon ths, during which two patients had died of metastatic disease. The sur gical approach with cardiopulmonary bypass and deep hypothermic circul atory arrest is well tolerated and can be used to facilitate complete tumour thrombectomy, with low operative risk. Need for caval tumour th rombectomy was found in 5% of all patients with renal cell carcinoma d uring the study period.