Complete and safe resection of challenging retroperitoneal tumors: anticipation of multi-organ and major vascular resection and use of adjunct procedures

• Main Authors: Tseng William W, Wang Sam C, Eichler Charles M, Warren Robert S, Nakakura Eric K
• Format: Article
• Language: English
• Published: BMC 2011-11-01
• Series: World Journal of Surgical Oncology
• Subjects: Retroperitoneal Tumor; Multi-organ Resection; Adjunct Procedures
• Online Access: http://www.wjso.com/content/9/1/143

<p>Abstract</p> <p>Background</p> <p>Retroperitoneal tumors are often massive and can involve adjacent organs and/or vital structures, making them difficult to resect. Completeness of resection is within the surgeon's control and critical for long-term survival, particularly for malignant disease. Few studies directly address strategies for complete and safe resection of challenging retroperitoneal tumors.</p> <p>Methods</p> <p>Fifty-six patients representing 63 cases of primary or recurrent retroperitoneal tumor resection between 2004-2009 were identified and a retrospective chart review was performed. Rates of complete resection, use of adjunct procedures, and perioperative complications were recorded.</p> <p>Results</p> <p>In 95% of cases, complete resection was achieved. Fifty-eight percent of these cases required en bloc multi-organ resection, and 8% required major vascular resection. Complete resection rates were higher for primary versus recurrent disease. Adjunct procedures (ureteral stents, femoral nerve monitoring, posterior laminotomy, etc.) were used in 54% of cases. Major postoperative complications occurred in 16% of cases, and one patient died (2% mortality).</p> <p>Conclusions</p> <p>Complete resection of challenging retroperitoneal tumors is feasible and can be done safely with important pre- and intraoperative considerations in mind.</p>