tailieunhanh - Báo cáo khoa học: "Renal carcinoma infiltrating inferior vena cava and combined valvular heart disease - one-stage uro-cardiological procedure: a case report"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Renal carcinoma infiltrating inferior vena cava and combined valvular heart disease - one-stage uro-cardiological procedure: a case report | Antoniewicz et al. World Journal of Surgical Oncology 2010 8 63 http content 8 1 63 WORLD JOURNAL OF SURGICAL ONCOLOGY CASE REPORT Open Access Renal carcinoma infiltrating inferior vena cava and combined valvular heart disease - one-stage uro-cardiological procedure a case report 1 1 2 1 1 Artur A Antoniewicz Slawomir Poletajew Andrzej Biederman Lukasz Zapala Andrzej Borowka Abstract Standard treatment of patients with coexisting cardiac and non-cardiac diseases includes two separate operations. We report a case of 55-year-old man with combined valvular heart disease and renal carcinoma infiltrating inferior caval vein who underwent one-stage cardio-urologic procedure. In the first step mitral and tricuspid valvuloplasty were performed by cardiac surgeons. Then urologists performed radical nephrectomy and thrombectomy. The postoperative course was uneventful. In twelve months follow-up the patient shows no signs of reccurrence and he had no symptoms of cardiac disease. To the best of our knowledge such a case has never been reported before in the literature. Background Coexistence of cardiac and non-cardiac diseases requiring surgical treatment has been a matter of debate for many years. The major problem concerns patients suffering from cardiac and oncologic diseases. The strategy of two separate procedures should be taken into consideration when consulting such a case. However if the cardiac operation is performed first the oncologic treatment is delayed and the chances for success are poorer. Furthermore the immunosuppressive effect of extracorporeal circulation may accelerate tumor growth and disseminate cancer cells 1 . If oncologic operation is performed first the risk of operation is very high due to heart status. There is also an aspect of risk and cost of two hospital stays and additional anaesthesia. In this group of p atients cardiac and non-cardiac operation performed under single anaesthesia seems to be interesting therapeutic option. .

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