Role of Cardiopulmonary Bypass Technique in Treatment of Abdominal Soft Tissue Tumor Invading Vena Cava System_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 XUJing ¹ , LIHua ² , YANGHua ³ , TONGHan-xing ¹ ,  XUDe-min ² ,  LUWei-qi ¹

1. Department of General Surgery/Department of Abdominal Soft Tissue tumor Surgery, Zhongshan Hospital of Fudan University, Shanghai 200032, China;
2. Department of Cardiac Surgery, Zhongshan Hospital of Fudan University, Shanghai 200032, China;
3. Department of General Surgery, South Branch of Zhongshan Hospital of Fudan University, Shanghai 200083, China;

Corresponding author：

XUDe-min, Email: xu.demin@zs-hospital.sh.cn; LUWei-qi, Email: lu.weiqi@zs-hospital.sh.cn

Keywords：

Cardiopulmonary bypass; Abdominal soft tissue tumor; Application

DOI：

10.7507/1007-9424.20160078

Video：

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Objective To evaluate the role of cardiopulmonary bypass (CPB) technique in the treatment of the abdominal soft tissue tumor (ASTT). Method Clinical data of 9 patients with ASTT who underwent CPB-aided resection in zhongshan Hospital of Fudan University from April 2011 to December 2015 were analyzed retrospectively. Results All patients were performed complete resection of tumor, without perioperative death. Six patients received complete CPB technique and other 3 patients received partial CPB technique. In establishment of CPB, patterns of arterial perfusion included the ascending aorta (n=6) and femoral artery (n=3); patterns of venous drainage included the inferior vena cava (n=2), superior vena cava (n=6), femoral vein (n=2), and jugular vein (n=3). Among of them, 7 patients were diagnosed as intravenous leiomyomatosis, 1 patient was diagnosed as small round cell malignant tumor, and another 1 patient was diagnosed as leiomyosarcoma. Two patients occurred postoperative complications, 1 patient was duodenal fistula, with conservative treatment to heal; another 1 patient was inferior vena cava thrombosis, with treatment of placement of the inferior vena cava filter. Nine patients received follow-up, and follow-up time was 1-57 months (the median time was 4-month), and the survival rate was 100%, no one suffered from recurrence. Conclusions For some patients with complicated ASTT, CPB technique can provide chance to completely resect the tumors.

Citation： XUJing, LIHua, YANGHua, TONGHan-xing, XUDe-min, LUWei-qi. Role of Cardiopulmonary Bypass Technique in Treatment of Abdominal Soft Tissue Tumor Invading Vena Cava System. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2016, 23(3): 282-285. doi: 10.7507/1007-9424.20160078 Copy

1.	Jemal A, Siegel R, Xu J, et al. Cancer statistics, 2010. CA Cancer J Clin, 2010, 60(5): 277-300.
2.	Ferrario T, Karakousis CP. Retroperitoneal sarcomas: grade and survival. Arch Surg, 2003, 138(3): 248-251.
3.	Kaliszewski K, Bednarz W, Łukieńczuk T, et al. Retroperitoneal tumours analysis of own clinical material-a six-year retrospective study. Hepatogastroenterology, 2010, 57(97): 47-51.
4.	Theman T, Williams WG, Simpson JS, et al. Tumor invasion of the upper inferior vena cava: the use of profound hypothermia and circulation arrest as a surgical adjunct. J Pediatr Surg, 1978, 13(3): 331-334.
5.	Ein SH, Shandling B, Williams WG, et al. Major hepatic tumor resection using profound hypothermia and circulation arrest. J Pediatr Surg, 1981, 16(3): 339-342.
6.	Marshall FF, Reitz BA. Technique for removal of renal cell carcinoma with suprahepatic vena caval tumor thrombus. Urol Clin North Am, 1986, 13(3): 551-557.
7.	Okazumi S, Asano T, Ryu M, et al. Surgical resection of adrenal carcinoma extending into the vena cava, right atrium and ventricle: case report and review of the literature. Nihon Geka Gakkai Zasshi, 1987, 88(2): 231-238.
8.	李佳春, 江朝光, 李功宋, 等. 体外循环技术用于非心脏外科手术8例. 中华胸心血管外科杂志, 1995, 11(2): 65-66.
9.	Angermeier KW, Ross JH, Novick AC, et al. Resection of nonrenal retroperitoneal tumors with large vena caval thrombi using cardiopulmonary bypass and hypothermic circulatory arrest. J Urol, 1990, 144(3): 735-739.
10.	Yie K, Ryu SM, Cho SJ. Metastasis after resection of huge primary pericardial pleomorphic liposarcoma with cardiopulmonary bypass. Thorac Cardiovasc Surg, 2010, 58(2): 113-115.
11.	Shudo Y, Matsumiya G, Sakaguchi T, et al. Resection of advanced stage malignant retroperitoneal neoplasms with tumor thrombus extending into the right atrium: report of four cases. Surg Today, 2011, 41(2): 262-265.
12.	Wise KB, Said SM, Clark CJ, et al. Resection of a giant primary synovial sarcoma of the inferior vena cava extending into the right atrium with caval reconstruction under cardiopulmonary bypass and circulatory arrest. Perspect Vasc Surg Endovasc Ther, 2012, 24(2): 95-101.
13.	师英强, 姚阳. 软组织肉瘤诊治中国专家共识(2015年版). 上海: 复旦大学出版社, 2015: 25-29.
14.	Bonvalot S, Rivoire M, Castaing M, et al. Primary retroperitoneal sarcomas: a multivariate analysis of surgical factors associated with local control. J Clin Oncol, 2009, 27(1): 31-37.
15.	Lewis JJ, Leung D, Woodruff JM, et al. Retroperitoneal soft-tissue sarcoma-analysis of 500 patients treated and followed at a single institution. Ann Surg, 1998, 228(3): 355-363.
16.	陆维祺. 多学科诊疗模式下腹部软组织肿瘤的诊治. 外科理论与实践, 2012, 17(4): 312-313.
17.	谢斌, 王春生, 张勇, 等. 心脏内平滑肌瘤病伴腹盆腔巨大肿瘤的多学科综合诊治策略(附2例报告). 外科理论与实践, 2012, 17(4): 332-338.
18.	Miah AB, Hannay J, Benson C, et al. Optimal management of primary retroperitoneal sarcoma: an update. Expert Rev Anticancer Ther, 2014, 14(5): 565-579.
19.	罗成华, 唐建军, 李荣, 等. 盆部腹膜外软组织肿瘤B超、CT、MRI表现与手术对照研究之外科意义. 中国医学影像学杂志, 2004, 12(2): 90-92, 132.
20.	陈唯韫, 朱斌, 刘兴荣, 等. 经食管超声心动图用于累及右心的下腔静脉瘤栓切除术的临床价值. 中华麻醉学杂志, 2014, 34(5): 593-596.
21.	Simon RM, Kim T, Espiritu P, et al. Effect of utilization of veno-venous bypass vs. cardiopulmonary bypass on complications for high level inferior vena cava tumor thrombectomy and concomitant radical nephrectomy. Int Braz J Uro, 2015, 41(5): 911-919.
22.	Zhang Y, Zhu J, Wang C, et al. Multimodality treatment of two cases of intracardiac leiomyomatosis with enormous mass in the abdominopelvic cavity. Expert Rev Anticancer Ther, 2013, 13(2): 137-141.
23.	Goyle KK, Moore DF, Garrett C, et al. Benign metastasizing leiom-yomatosis: case report and review. Am J Clin Oncol, 2003, 26(5): 473-476.
24.	马国涛, 苗齐, 任华, 等. 腔静脉瘤栓延伸至右侧心腔的诊断和外科治疗. 基础医学与临床, 2009, 29(4): 431-435.
25.	Yamashita C, Azami T, Okada M, et al. Usefulness of cardiopul-monary bypass in reconstruction of inferior vena cava occupied by renal cell carcinoma tumor thrombus. Angiology, 1999, 50(1): 47-53.
26.	Hiraishi T, Kobayashi T, Sakurai M, et al. Usefulness of normothe-rmic extracorporeal circulation for surgical treatment of malignant retroperitoneal tumor with extension into inferior vena cava. Jpn J Cardiovasc Surg, 1992, 21: 540-543.

1. Jemal A, Siegel R, Xu J, et al. Cancer statistics, 2010. CA Cancer J Clin, 2010, 60(5): 277-300.
2. Ferrario T, Karakousis CP. Retroperitoneal sarcomas: grade and survival. Arch Surg, 2003, 138(3): 248-251.
3. Kaliszewski K, Bednarz W, Łukieńczuk T, et al. Retroperitoneal tumours analysis of own clinical material-a six-year retrospective study. Hepatogastroenterology, 2010, 57(97): 47-51.
4. Theman T, Williams WG, Simpson JS, et al. Tumor invasion of the upper inferior vena cava: the use of profound hypothermia and circulation arrest as a surgical adjunct. J Pediatr Surg, 1978, 13(3): 331-334.
5. Ein SH, Shandling B, Williams WG, et al. Major hepatic tumor resection using profound hypothermia and circulation arrest. J Pediatr Surg, 1981, 16(3): 339-342.
6. Marshall FF, Reitz BA. Technique for removal of renal cell carcinoma with suprahepatic vena caval tumor thrombus. Urol Clin North Am, 1986, 13(3): 551-557.
7. Okazumi S, Asano T, Ryu M, et al. Surgical resection of adrenal carcinoma extending into the vena cava, right atrium and ventricle: case report and review of the literature. Nihon Geka Gakkai Zasshi, 1987, 88(2): 231-238.
8. 李佳春, 江朝光, 李功宋, 等. 体外循环技术用于非心脏外科手术8例. 中华胸心血管外科杂志, 1995, 11(2): 65-66.
9. Angermeier KW, Ross JH, Novick AC, et al. Resection of nonrenal retroperitoneal tumors with large vena caval thrombi using cardiopulmonary bypass and hypothermic circulatory arrest. J Urol, 1990, 144(3): 735-739.
10. Yie K, Ryu SM, Cho SJ. Metastasis after resection of huge primary pericardial pleomorphic liposarcoma with cardiopulmonary bypass. Thorac Cardiovasc Surg, 2010, 58(2): 113-115.
11. Shudo Y, Matsumiya G, Sakaguchi T, et al. Resection of advanced stage malignant retroperitoneal neoplasms with tumor thrombus extending into the right atrium: report of four cases. Surg Today, 2011, 41(2): 262-265.
12. Wise KB, Said SM, Clark CJ, et al. Resection of a giant primary synovial sarcoma of the inferior vena cava extending into the right atrium with caval reconstruction under cardiopulmonary bypass and circulatory arrest. Perspect Vasc Surg Endovasc Ther, 2012, 24(2): 95-101.
13. 师英强, 姚阳. 软组织肉瘤诊治中国专家共识(2015年版). 上海: 复旦大学出版社, 2015: 25-29.
14. Bonvalot S, Rivoire M, Castaing M, et al. Primary retroperitoneal sarcomas: a multivariate analysis of surgical factors associated with local control. J Clin Oncol, 2009, 27(1): 31-37.
15. Lewis JJ, Leung D, Woodruff JM, et al. Retroperitoneal soft-tissue sarcoma-analysis of 500 patients treated and followed at a single institution. Ann Surg, 1998, 228(3): 355-363.
16. 陆维祺. 多学科诊疗模式下腹部软组织肿瘤的诊治. 外科理论与实践, 2012, 17(4): 312-313.
17. 谢斌, 王春生, 张勇, 等. 心脏内平滑肌瘤病伴腹盆腔巨大肿瘤的多学科综合诊治策略(附2例报告). 外科理论与实践, 2012, 17(4): 332-338.
18. Miah AB, Hannay J, Benson C, et al. Optimal management of primary retroperitoneal sarcoma: an update. Expert Rev Anticancer Ther, 2014, 14(5): 565-579.
19. 罗成华, 唐建军, 李荣, 等. 盆部腹膜外软组织肿瘤B超、CT、MRI表现与手术对照研究之外科意义. 中国医学影像学杂志, 2004, 12(2): 90-92, 132.
20. 陈唯韫, 朱斌, 刘兴荣, 等. 经食管超声心动图用于累及右心的下腔静脉瘤栓切除术的临床价值. 中华麻醉学杂志, 2014, 34(5): 593-596.
21. Simon RM, Kim T, Espiritu P, et al. Effect of utilization of veno-venous bypass vs. cardiopulmonary bypass on complications for high level inferior vena cava tumor thrombectomy and concomitant radical nephrectomy. Int Braz J Uro, 2015, 41(5): 911-919.
22. Zhang Y, Zhu J, Wang C, et al. Multimodality treatment of two cases of intracardiac leiomyomatosis with enormous mass in the abdominopelvic cavity. Expert Rev Anticancer Ther, 2013, 13(2): 137-141.
23. Goyle KK, Moore DF, Garrett C, et al. Benign metastasizing leiom-yomatosis: case report and review. Am J Clin Oncol, 2003, 26(5): 473-476.
24. 马国涛, 苗齐, 任华, 等. 腔静脉瘤栓延伸至右侧心腔的诊断和外科治疗. 基础医学与临床, 2009, 29(4): 431-435.
25. Yamashita C, Azami T, Okada M, et al. Usefulness of cardiopul-monary bypass in reconstruction of inferior vena cava occupied by renal cell carcinoma tumor thrombus. Angiology, 1999, 50(1): 47-53.
26. Hiraishi T, Kobayashi T, Sakurai M, et al. Usefulness of normothe-rmic extracorporeal circulation for surgical treatment of malignant retroperitoneal tumor with extension into inferior vena cava. Jpn J Cardiovasc Surg, 1992, 21: 540-543.

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Role of Cardiopulmonary Bypass Technique in Treatment of Abdominal Soft Tissue Tumor Invading Vena Cava System

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