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Query: UMLS:C0020672 (hypothermia)
 17,327 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

An operation is indicated in patients with renal cancer growing into the inferior vena cava and right atrium because the tumor in the right atrium presents an immediate risk to life if acute obstruction of the tricuspid valve or pulmonary emboli occur. In addition, patients treated by such an operation may enjoy reasonable survivals. We believe that the best technique for operative management includes cardiopulmonary bypass, profound hypothermia and total circulatory arrest. Although perhaps seemingly complicated, it is the only technique that simplifies the operative dissection and permits as complete removal as possible of the cancer without the risk of tumor embolization or uncontrollable hemorrhage.
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PMID:Removal of renal cell carcinoma extending into the right atrium using cardiopulmonary bypass, profound hypothermia and circulatory arrest. 670 32

A renal parenchymal sparing surgical approach may be recommended in select patients with von Hippel-Lindau disease and renal cancer or in those with sporadic renal cancer and limited normal renal function. We performed 27 partial nephrectomies or enucleations in 17 patients with the use of intraoperative ultrasound to examine a subset of all renal lesions identified on preoperative examination. Of 24 lesions deep in the renal parenchyma that were examined, localized or identified with intraoperative ultrasound 18 were characterized as cystic and 6 as solid. The deep cystic lesions were characterized with ultrasound as benign simple cysts. Intraoperative ultrasound was used to locate and mark the line of incision over 2 impalpable solid renal cell carcinomas. Four solid renal cell tumors extended deep into the renal parenchyma where color Doppler intraoperative ultrasound helped to define the plane of dissection adjacent to vital vascular structures. Renal hypothermia was not used in 3 renal operations based on intraoperative ultrasound findings.
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PMID:Evaluation of color Doppler intraoperative ultrasound in parenchymal sparing renal surgery. 796 58

Due to the considerable progress made by instrumental total body diagnostics (ECO, CAT, RMN, angiography, etc.) in recent years heart surgery has increasingly often been used to treat pathologies which are not primarily cardiac but which see the involvement of the heart and large vessels in the advanced stages of cancer and non-cancer diseases of other organs or apparatus. This is the case of malignant renal or adrenal tumours which infiltrate along the caval lumen until they reach the right atrium. In these cases caval and atrial involvement must be seen as a prolapse of the tumour and not a long-distance metastasis: prognosis only appears to be linked to the hemodynamic impairment caused by the obstacle to systemic lower venous drainage. On the bases of this observation radical surgery may be justified at a renal, caval and cardiac level. The authors report their preliminary experience in 6 patients with renal cancer (4 renal carcinoma, 1 Wilm's tumour, 1 adrenal carcinoma) who underwent combined surgery, in a single stage, involving enlarged nephrectomny and caval and atrial thrombectomy, the latter performed in profound hypothermia and cardiocirculatory arrest. Two patients died later and 4 are living, in good condition and with perviousness of the lower caval venous drainage. Similar to other analogous experience reported in the literature, the authors suggest taking a combined approach performed in a single stage into consideration for these patients.
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PMID:[Neoplastic caval and intracardiac thrombosis secondary to reno-adrenal tumors. One-stage surgical treatment in deep hypothermia and cardiocirculatory arrest]. 797 82

A retrospective study of 118 patients with renal cancer, treated at the University Urologic Clinic in Rostock, Germany, for the period Jan. 1980-March 1990 was performed. Twenty-one patients (17.8 per cent) were in advanced stage of the disease which made operative treatment impossible. Radical nephrectomy was performed in 83 patients: transperitoneal with pararectal approach in 79 and lumbotomy in 4. Partial renal resection was performed in 7 patients, in 5 of them with local hypothermia. The operation in 7 patients terminated with probatory laparotomy because of infiltrative growth of the tumor in adjacent tissues, v. cava included. Probatory laparotomy served for intraoperative biopsy, allowing to establish histologic diagnosis. Six patients died within a month after the operation (6.15 per cent postoperative lethality). Intraoperative complications developed in 4 patients: rupture of the spleen in 2 requiring splenectomy, lesion of colon descendens which necessitated transversectomy--in 1 patient, and rupture of the aorta in 1 patient successfully controlled with two-layer suture of the aortic wall.
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PMID:[The surgical treatment of patients with renal carcinoma]. 841 80

Nephron-sparing surgery in renal cell carcinoma is an accepted approach in patients with bilateral carcinomas, solitary kidneys and in patients with chronic renal failure in whom radical nephrectomy would necessitate immediate renal replacement therapy (mandatory indications). Because of the improvement of operative techniques-like renal perfusion in hypothermia or work-bench surgery-over 95% of patients can spared dialysis even if multiple tumors or locally advanced renal cancer is present. Based on the excellent outcome of nephron-sparing surgery in mandatory indications (5-year survival rates over 80%), several centers advocate extending the use of partial nephrectomy to selected patients with a normal opposite kidney (elective indications). Several reports on nephron-sparing surgery in elective indications with a median follow-up time of 40 months document similar survival rates compared to radical nephrectomy. Nevertheless, due to the low incidence of bilateral renal carcinomas (under 2%), only 2 of 100 patients would benefit from this approach. Furthermore, local recurrence after nephron-sparing surgery occurs mostly after 4 years (late recurrence); therefore, it seems doubtful whether the short follow-up times really reveal the the true recurrence rate. The prognosis after development of a local recurrence is poor.
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PMID:[Status of organ preserving surgery in renal cell carcinoma]. 919 36

The conservative management of kidney cancer is widely accepted as a therapeutic option for tumours measuring less than 4 cm or in case of underlying renal disease and solitary kidney. The functional and carcinologic success of this conservative treatment results from a radical resection of the tumour and a careful repair of the collecting system and selective ligature of the vessels. Kidney artery clamping is a key to reach these objectives. The cooling of the kidney preserves from warm ischemia and reperfusion lesions. In this review, we explain the physiological basis of warm ischemia induced kidney lesions due to the kidney artery clamping and the advantage of hypothermia. The surgical technique as described by Novick is detailed. This well standardized technique has the advantage of being reproducible and adaptable to all situations.
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PMID:[Conservative treatment of upper urinary tract tumours]. 1733 96