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
Tertiary university hospital and State Sarcoma Center.
Patients undergoing retroperitoneal sarcoma resection requiring reconstruction of the inferior vena cava (IVC) between June 2018 and March 2022.
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%.
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.
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