Abstract：
To describe the introduction of extracorporeal corporeal oxygenation (ECMO) to facilitate the surgical resection of large retroperitoneal sarcomas involving major vessels and to report preliminary outcomes.
A case series.
At a tertiary university hospital and state sarcoma center.
Patients undergoing retroperitoneal sarcoma resection requiring inferior vena cava (IVC) reconstruction between June 2018 and March 2022.
ECMO for retroperitoneal tumor resection requiring IVC reconstruction.
A total of 20 patients underwent ECMO-assisted retroperitoneal sarcoma resection and IVC reconstruction. The median age was 60.5 years (IQR 48-69); 15 women and 5 men. The median procedure and ECMO durations were 10.8 hours (IQR 8.5-12.4 hours) and 2.2 hours (IQR 62-218 minutes), respectively. The median intensive care unit and hospital lengths of stay were 4 days (IQR 3-5 days) and 21 days (IQR 14-31 days), respectively. All 20 patients received packed cell transfusions (median 8 per patient [IQR 4-14]); 11 patients required fresh frozen plasma, 6 required platelets, and 11 required fibrinogen supplementation. One patient required recombinant activated factor VII. Sixteen patients experienced acute kidney injury, with 12 patients progressing to chronic kidney disease. Three patients were 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%.
ECMO for resecting large retroperitoneal tumor resection was introduced successfully and facilitated satisfactory outcomes for many patients who might otherwise have been considered too high risk.
A case series.
At a tertiary university hospital and state sarcoma center.
Patients undergoing retroperitoneal sarcoma resection requiring inferior vena cava (IVC) reconstruction between June 2018 and March 2022.
ECMO for retroperitoneal tumor resection requiring IVC reconstruction.
A total of 20 patients underwent ECMO-assisted retroperitoneal sarcoma resection and IVC reconstruction. The median age was 60.5 years (IQR 48-69); 15 women and 5 men. The median procedure and ECMO durations were 10.8 hours (IQR 8.5-12.4 hours) and 2.2 hours (IQR 62-218 minutes), respectively. The median intensive care unit and hospital lengths of stay were 4 days (IQR 3-5 days) and 21 days (IQR 14-31 days), respectively. All 20 patients received packed cell transfusions (median 8 per patient [IQR 4-14]); 11 patients required fresh frozen plasma, 6 required platelets, and 11 required fibrinogen supplementation. One patient required recombinant activated factor VII. Sixteen patients experienced acute kidney injury, with 12 patients progressing to chronic kidney disease. Three patients were 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%.
ECMO for resecting large retroperitoneal tumor resection was introduced successfully and facilitated satisfactory outcomes for many patients who might otherwise have been considered too high risk.
摘要：
目的：介绍体外自体氧合（ECMO），以促进累及主要血管的大型腹膜后肉瘤的手术切除，并报告初步结果。
方法：案例系列。
方法：在三级大学医院和州肉瘤中心。
方法：在2018年6月至2022年3月期间接受腹膜后肉瘤切除术需要下腔静脉（IVC）重建的患者。
方法：ECMO用于需要IVC重建的腹膜后肿瘤切除术。
结果：共有20例患者接受了ECMO辅助的腹膜后肉瘤切除术和IVC重建。中位年龄为60.5岁（IQR48-69）；15名女性和5名男性。中位手术时间和ECMO持续时间分别为10.8小时（IQR8.5-12.4小时）和2.2小时（IQR62-218分钟），分别。中位重症监护病房和住院时间为4天（IQR3-5天）和21天（IQR14-31天），分别。所有20例患者均接受打包细胞输血（每位患者中位8例[IQR4-14]）；11例患者需要新鲜冰冻血浆，6个必需的血小板，11需要补充纤维蛋白原。一名患者需要重组激活的因子VII。16例患者出现急性肾损伤,有12名患者进展为慢性肾脏病。三名患者被要求在7天内返回手术室，前24小时内没有退货。没有住院或30天死亡。3年生存率为84%。
结论：ECMO用于切除大型腹膜后肿瘤切除术已成功引入，并为许多可能被认为风险过高的患者带来了令人满意的结果。
方法：案例系列。
方法：在三级大学医院和州肉瘤中心。
方法：在2018年6月至2022年3月期间接受腹膜后肉瘤切除术需要下腔静脉（IVC）重建的患者。
方法：ECMO用于需要IVC重建的腹膜后肿瘤切除术。
结果：共有20例患者接受了ECMO辅助的腹膜后肉瘤切除术和IVC重建。中位年龄为60.5岁（IQR48-69）；15名女性和5名男性。中位手术时间和ECMO持续时间分别为10.8小时（IQR8.5-12.4小时）和2.2小时（IQR62-218分钟），分别。中位重症监护病房和住院时间为4天（IQR3-5天）和21天（IQR14-31天），分别。所有20例患者均接受打包细胞输血（每位患者中位8例[IQR4-14]）；11例患者需要新鲜冰冻血浆，6个必需的血小板，11需要补充纤维蛋白原。一名患者需要重组激活的因子VII。16例患者出现急性肾损伤,有12名患者进展为慢性肾脏病。三名患者被要求在7天内返回手术室，前24小时内没有退货。没有住院或30天死亡。3年生存率为84%。
结论：ECMO用于切除大型腹膜后肿瘤切除术已成功引入，并为许多可能被认为风险过高的患者带来了令人满意的结果。
