205 * RESECTION OF MEDIASTINAL MALIGNOMA WITH THE USE OF CARDIOPULMONARY BYPASS

Abstract

Objectives: The benefit of malignant mediastinal tumour resection with the help of cardiopulmonary bypass remains unclear. Here we report our 10-year single-centre experience. Methods: We retrospectively analysed perioperative data and follow-up of patients who underwent malignant tumour resections with the use of cardiopulmonary bypass in our department between 2003 and 2013. The mean follow-up time was 25 ± 32 (range 4-112) months. Results: Thirteen patients (77% female) with a mean age of 55 ± 16 (range 24- 80) years were identified, of whom 10 (seven female) were diagnosed with primary mediastinal malignoma and three with malignant metastases. The malignoma had heterogenic aetiology: three sarcoma, two thymoma, two paraganglioma, one rhabdomyosarcoma, one carcinoid, and one non- Hodgkin's lymphoma. Primary tumours of the metastastes were chondrosarcoma, osteosarcoma and malignant melanoma. Three patients died within the hospital stay, one of whom underwent an ex situ cardiac tumour resection with complete left atrial reconstruction. The mean bypass time was 156 ± 104 (range 55-405) min. Six patients required aortic cross-clamping (mean time 50 ± 68 (range 36-173) min. The intra-aortic balloon pump was implanted intraoperatively in two patients, and extracorporeal membrane oxygenation postoperatively in one patient. Five patients are still alive. Actuarial survival was 67 ± 14% at one year and 29 ± 14% at five years. Conclusions: Patients undergoing resection of mediastinal malignoma with infiltration of the great vessels or cardiac structures, requiring cardiopulmonary bypass, may undergo advanced operative procedures with an acceptable oneyear- survival, but long-term survival remains poor.