For a study, researchers sought to assess the cognitive outcomes of patients receiving open radical nephrectomy (RN), inferior vena cava (IVC) thrombectomy, and profound hypothermic circulatory arrest with vs. without cardiopulmonary bypass (CPB).
From January 2013 to December 2019, a prospective, 6-month observational analysis of renal cell carcinoma patients receiving RN and having level II-IV IVC thrombus was carried out. Before surgery, 1 week after surgery, and 6 months later, a battery of standardized neuropsychological tests was administered to evaluate each patient’s multi-domain cognitive function, including attention, executive functions, working memory, short- and long-term delay recall, visuomotor speed, and verbal fluency.
A 20% decrease in at least 20% of the primary factors was deemed cognitively impaired. The incidence of cognitive impairment at 6 months postoperatively was the main outcome, and general linear mixed models were used to assess it. Analysis was done on 26 patients who received CPB and 39 patients who received non-CPB treatment. Between the two groups, there were no discernible variations in cognitive impairment. At one week following surgery, the incidence of cognitive impairment was 38.5% in the CPB group and 30.8% in the non-CPB group (P =.52); at 6 months, the incidence was 11.5% and 10.3% (P = 1.00). According to a multivariate analysis, the sole risk factor for cognitive impairment 1 week after surgery was the predicted blood loss.
In the research, patients with renal cell carcinoma who had open RN and IVC thrombectomy with or without CPB and profound hypothermic circulatory arrest revealed no significant variations in their postoperative to cognitive performance. Cognitive impairment was discovered to be related to estimated blood loss 6 months after surgery.