Hepatocellular Carcinoma Extending into Right Atrium was Resected Successfully Using Cardiopulmonary Bypass

Yasuhiro Tani, Takahito Nakagawa, Toshiya Kamiyama, Kazuaki Nakanishi, Daisuke Fukumori, Hirofumi Kamachi, Kazuhito Uemura, Michiaki Matushita, Norihiko Shiiya* and Satoru Todo

Department of Gastroenterology and General Surgery and Department of Cardiovascular Surgery*, Hokkaido University School of Medicine

Hepatocellular carcinoma (HCC) extending into the right atrium is far advanced, and the benefits of surgical resection are controversial. As surgical techniques in liver resection have been improved, some reports have indicated that the surgical resection of HCC with the tumor thrombus at the atrium improved prognosis, and prevented sudden death caused by pulmonary embolism or heart failure. A 68-year-old man who had undergone right pneumonectomy had HCC and a tumor thrombus extending into the right atrium. He underwent hepatectomy with removal of the tumor thrombus using cardiopulmonary bypass. Right hepatectomy was done with an anterior approach and very careful homeostasis, in succession with tumor thrombectomy under cardiopulmonary bypass. Operation time was 7 hr 29 min and blood loss 2,750 ml, with 4 minutes of cardiopulmonary bypass. He remains alive and well in the 11 months since hepatectomy.

Key words
hepatocellular carcinoma, intra-atrial tumor thrombus, cardiopulmonary bypass

Reprint requests
Yasuhiro Tani Department of Gastroenterology and General Surgery, Hokkaido University School of Medicine
Kita-15 Nishi-7 Kita-ku, Sapporo, 060-8638 JAPAN

Accepted
September 28, 2005

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