Abstract
Objective
To describe the introduction of an extracorporeal corporeal oxygenation (ECMO) service
to facilitate surgical resection of large retroperitoneal sarcomas involving major
vessels, and to report preliminary outcomes
Design
Case Series
Setting
Tertiary university hospital and State Sarcoma Center.
Participants
Patients undergoing retroperitoneal sarcoma resection requiring reconstruction of
the inferior vena cava (IVC) between June 2018 and March 2022.
Intervention
ECMO for retroperitoneal tumor resection requiring IVC reconstruction.
Measurements and Main Results
20 patients underwent ECMO-assisted retroperitoneal sarcoma resection and IVC reconstruction.
Median age was 60.5 years (IQR 48-69); 15 female, 5 male. Median procedure and ECMO
durations were 10.8 hours (IQR 8.5 - 12.4hours) and 2.2 hours (IQR 62-218 minutes)
respectively. Median intensive care unit (ICU) and hospital length of stay were 4
days (IQR 3-5 days) and 21 days (IQR 14-31 days) respectively. All 20 patients received
packed cell (PRBC) transfusions(median 8 per patient (IQR 4-14)). 11 patients required
fresh frozen plasma, six required platelets and 11 required fibrinogen supplementation.
One patient required recombinant activated factor seven. 16 patients experienced acute
kidney injury with 12 patients progressing to chronic kidney disease. Three patients
required to return to the operating room within 7 days with no returns within the
first 24 hours. There was no in-hospital or 30-day mortality. Survival at 3 years
was 84%.
Conclusions
An ECMO service for resection of large retroperitoneal tumor resection was introduced
successfully and facilitated satisfactory outcomes for many patients who might otherwise
have been considered too high risk.
Keywords
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Article info
Publication history
Publication stage
In Press Accepted ManuscriptIdentification
Copyright
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