The use of intraoperative ECMO support in pediatric oncosurgery: a clinical observation
A. A. Tsintsadze,
N. V. Matinyan,
P. A. Kerimov,
O. M. Romantsova,
E. V. Zilbert,
P. E. Kolpakov,
E. A. Kovaleva,
D. A. Kuznetsov,
E. I. Belousova,
Kh. A. Aleskerova,
A. S. Temny,
V. P. Akimov,
R. V. Milutis https://doi.org/10.24884/2078-5658-2026-23-3-90-99
Abstract
Introduction. Spontaneous pneumothorax as the onset of metastatic osteosarcoma in children is extremely rare. In the present case, massive involvement of the peripheral lung segments in a patient with osteosarcoma of the right tibia led to the development of bilateral spontaneous pneumothorax. Effective polychemotherapy resulted in a significant reduction in the number of metastases; however, the extensive adhesions that formed against the background of metastatic regression, combined with the multiple pleural drainages performed at the onset of the disease, created obstacles to further surgical treatment.
The objective was to demonstrate the successful use of intraoperative veno-venous extracorporeal membrane oxygenation (VV-ECMO) to prevent critical respiratory complications and ensure the safety of anesthetic management.
Materials and methods. We present the clinical case of a 15-year-old patient with osteosarcoma of the right tibia (stage T2N1M1). Due to the development of bilateral pneumothorax and the formation of massive adhesions in the pleural cavities, which prevented full lung expansion, bilateral thoracic surgery (adhesiolysis) was performed under intraoperative VV-ECMO.
Results. The use of VV-ECMO allowed for the safe performance of complete adhesiolysis, the re-expansion of both lungs, and the creation of conditions for subsequent radical treatment. The duration of ECMO support was 31 hours. Six weeks later, the patient successfully underwent right knee arthroplasty. The patient resumed his chemotherapy regimen.
Conclusion. This clinical case demonstrates that VV-ECMO can be effectively used not only as a method of emergency respiratory support but also as a routine tool for ensuring surgical safety in patients with severe respiratory limitations. The use of ECMO made it possible to overcome the limitations associated with the inability to safely ventilate the lungs, ensuring that adhesiolysis could be performed, followed by a transition to the radical phase of treatment six weeks later.
About the Authors
A. A. Tsintsadze
Academician L. A. Durnov Research Institute of Pediatric Oncology and Hematology, N. N. Blokhin National Medical Research Center of Oncology; I. M. Sechenov First Moscow State Medical University
Russian Federation
Russian Federation
Tsintsadze Anastasia A., Cand. of Sci. (Med.), Anesthesiologist-Intensivist, Department of Anesthesiology, Resuscitation and Intensive Care, Division of Anesthesiology and Resuscitation; Assistant, Department of Anesthesiology and Intensive Care, N. V. Sklifosovsky Institute of Clinical Medicine
24, Kashirskoye Shosse, Moscow, 115478
8, building 2, ul. Trubetskaya, Moscow, 119991
N. V. Matinyan
Academician L. A. Durnov Research Institute of Pediatric Oncology and Hematology, N. N. Blokhin National Medical Research Center of Oncology
Russian Federation
Russian Federation
Matinyan Nune V., Dr. of Sci. (Med.), Professor, Head of the Division of Anesthesiology and Resuscitation; Professor, Department of Pediatric Anesthesiology and Intensive Therapy, N. I. Pirogov Russian National Research Medical University
24, Kashirskoye Shosse, Moscow, 115478
P. A. Kerimov
Academician L. A. Durnov Research Institute of Pediatric Oncology and Hematology, N. N. Blokhin National Medical Research Center of Oncology
Russian Federation
Russian Federation
Kerimov Polad Akshin Ogly, Dr. of Sci. (Med.), Deputy Chief Physician for Surgery; Head of the Pediatric Oncological Department of Surgical Treatment Methods (Tumors of Thoracoabdominal Localization and Musculoskeletal System)
24, Kashirskoye Shosse, Moscow, 115478
O. M. Romantsova
Academician L. A. Durnov Research Institute of Pediatric Oncology and Hematology, N. N. Blokhin National Medical Research Center of Oncology
Russian Federation
Russian Federation
Romantsova Olga M., Pediatric Oncologist, Head of Pediatric Oncology Department № 2 (Chemotherapy of Musculoskeletal Tumors)
24, Kashirskoye Shosse, Moscow, 115478
E. V. Zilbert
N. I. Pirogov Russian National Research Medical University; N. F. Filatov Children’s City Clinical Hospital, Moscow Healthcare Department
Russian Federation
Russian Federation
Zilbert Elena V., Dr. of Sci. (Med.), Associate Professor, Department of Pediatric Surgery named after Academician Yu. F. Isakov, Institute of Motherhood and Childhood, Pediatric Faculty; Head of the Intensive Care Unit
1, ul. Ostrovityanova, Moscow, 117997
15, Sadovaya-Kudrinskaya ul., Moscow, 123001
P. E. Kolpakov
I. M. Sechenov First Moscow State Medical University
Russian Federation
Russian Federation
Kolpakov Pavel e., Cand. of Sci. (Med.), Anesthesiologist-Intensivist, Physician-Methodologist for Personnel Policy and Monitoring of Medical Care Organization
8, building 2, ul. Trubetskaya, Moscow, 119991
E. A. Kovaleva
Academician L. A. Durnov Research Institute of Pediatric Oncology and Hematology, N. N. Blokhin National Medical Research Center of Oncology
Russian Federation
Russian Federation
Kovaleva Ekaterina A., Anesthesiologist-Intensivist, Department of Anesthesiology, Resuscitation and Intensive Care
AuthorID: 1095035
24, Kashirskoye Shosse, Moscow, 115478
D. A. Kuznetsov
Academician L. A. Durnov Research Institute of Pediatric Oncology and Hematology, N. N. Blokhin National Medical Research Center of Oncology
Russian Federation
Russian Federation
Kuznetsov Dmitry A., Anesthesiologist-Intensivist, Department of Anesthesiology, Resuscitation and Intensive Care, Division of Anesthesiology and Resuscitation
24, Kashirskoye Shosse, Moscow, 115478
E. I. Belousova
Academician L. A. Durnov Research Institute of Pediatric Oncology and Hematology, N. N. Blokhin National Medical Research Center of Oncology
Russian Federation
Russian Federation
Belousova Ekaterina I., Cand. of Sci. (Med.), Anesthesiologist-Intensivist, Department of Anesthesiology, Resuscitation and Intensive Care, Division of Anesthesiology and Resuscitation
24, Kashirskoye Shosse, Moscow, 115478
Kh. A. Aleskerova
Academician L. A. Durnov Research Institute of Pediatric Oncology and Hematology, N. N. Blokhin National Medical Research Center of Oncology
Russian Federation
Russian Federation
Aleskerova Khayale Asif Kyzy, Pediatric Oncologist, Pediatric Oncology Department № 2 (Chemotherapy of Musculoskeletal Tumors)
24, Kashirskoye Shosse, Moscow, 115478
A. S. Temny
Academician L. A. Durnov Research Institute of Pediatric Oncology and Hematology, N. N. Blokhin National Medical Research Center of Oncology
Russian Federation
Russian Federation
Temny Aleksandr S., Cand. of Sci. (Med.), Pediatric Oncologist, Pediatric Oncological Department of Surgical Treatment Methods (Tumors of Thoracoabdominal Localization and Musculoskeletal System)
24, Kashirskoye Shosse, Moscow, 115478
V. P. Akimov
Academician L. A. Durnov Research Institute of Pediatric Oncology and Hematology, N. N. Blokhin National Medical Research Center of Oncology
Russian Federation
Russian Federation
Akimov Vasily P., Head of the Intensive Care Unit
24, Kashirskoye Shosse, Moscow, 115478
R. V. Milutis
Academician L. A. Durnov Research Institute of Pediatric Oncology and Hematology, N. N. Blokhin National Medical Research Center of Oncology
Russian Federation
Russian Federation
Milutis Raisa V., Anesthesiologist-Intensivist, Department of Anesthesiology and Resuscitation
24, Kashirskoye Shosse, Moscow, 115478
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Review
For citations:
Tsintsadze A.A., Matinyan N.V., Kerimov P.A., Romantsova O.M., Zilbert E.V., Kolpakov P.E., Kovaleva E.A., Kuznetsov D.A., Belousova E.I., Aleskerova Kh.A., Temny A.S., Akimov V.P., Milutis R.V. The use of intraoperative ECMO support in pediatric oncosurgery: a clinical observation. Messenger of ANESTHESIOLOGY AND RESUSCITATION. 2026;23(3):90-99. (In Russ.) https://doi.org/10.24884/2078-5658-2026-23-3-90-99
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