Surgical treatment of renal cell carcinoma with thrombosis of inferior vena cava and right atrium

2018 ◽  
Vol 0 (3) ◽  
pp. 75-79
Author(s):  
I. I. Kobza ◽  
Yu. S. Mota ◽  
S. A. Lebedeva ◽  
Yu. G. Orel ◽  
R. A. Zhuk
Keyword(s):  
Renal Cell Carcinoma ◽  
Surgical Treatment ◽  
Inferior Vena Cava ◽  
Cell Carcinoma ◽  
Right Atrium ◽  
Renal Cell ◽  
Inferior Vena ◽  
Vena Cava

Solitary Massive Right Ventricular Metastasis of Renal Cell Carcinoma Without Inferior Vena Cava or Right Atrium Involvement

2006 ◽  
Vol 21 (3) ◽  
pp. 304-306 ◽  
Author(s):  
Fernando A. Atik ◽  
Jose L. Navia ◽  
Venkatesh Krishnamurthi ◽  
Gurmeet Singh ◽  
Takahiro Shiota ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Inferior Vena Cava ◽  
Right Ventricular ◽  
Cell Carcinoma ◽  
Right Atrium ◽  
Renal Cell ◽  
Inferior Vena ◽  
Vena Cava

Results of surgical treatment of inferior vena cava tumor thrombi in renal cell carcinoma

2020 ◽  
Vol 99 (4) ◽  
pp. 167-171
Keyword(s):  
Renal Cell Carcinoma ◽  
Surgical Treatment ◽  
Inferior Vena Cava ◽  
Cell Carcinoma ◽  
Kidney Cancer ◽  
Renal Cell ◽  
Inferior Vena ◽  
Vena Cava ◽  
Oncological Treatment ◽  
Tumour Thrombus

Introduction: Thrombosis of inferior vena cava (IVC) is an important complication amongst oncological patients. Tumor thrombus of IVC is characteristic for patients with renal cell carcinoma, occurring in 10−18%. The aim of the work is to analyze of surgical treatment in patients with cancer thrombosis of inferior vena cava in kidney cancer. Methods: Between 2010 and 2019 we treated 32 patients with kidney cancer complicated by thrombotic infiltration of the inferior vena cava. According to Nesbitt classification the levels of thrombotic infiltration of the inferior vena cava were: I–8 (25%), II–14 (43.8%), III–6 (18.8%), and IV–4 (12.5%). Nephrectomy with thrombectomy of the cancer thrombus in the inferior vena cava was performed in all patients. In addition to laparotomy, sternotomy was approached in 4 patients with Nesbitt IV and in 2 patients with Nesbitt III. Results: Primary suture of IVC was performed in 26 patients; angioplasty of IVC was performed in 4 patients; and resection of IVC with replacement using a polytetrafluoroethylene interposition graft was done in 2 patients. Radical surgical treatment was performed in 27 (84.3%) patients, and palliative in 5 (15.6%) patients. In the postoperative period, 1 (3.1%) patient (Nesbitt IV) died of cardiac failure during hospitalisation. Two-year survival was observed in 75% of the cases. Conclusion: Tumorous infiltration of IVC is associated with a high potential for tumour embolisation to the lungs, leading to the formation of multiple metastases and spreading of the underlying disease. Postoperative comfort is improved considerably after nephrectomy of the affected kidney and removal of the tumour thrombus, including IVC resection as appropriate, and when combined with oncological treatment, the survival rate is increased significantly, as well.

scholarly journals Surgical Treatment of Renal Cell Carcinoma with Inferior Vena Cava Thrombus: Using Liver Mobilization Technique to Avoid Cardiopulmonary Bypass

2008 ◽  
Vol 31 (2) ◽  
pp. 75-82 ◽  
Author(s):  
Tawatchai Taweemonkongsap ◽  
Chaiyong Nualyong ◽  
Sunai Leewansangtong ◽  
Teerapon Amornvesukit ◽  
Yongyut Sirivatanauksorn ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Cardiopulmonary Bypass ◽  
Surgical Treatment ◽  
Inferior Vena Cava ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Inferior Vena ◽  
Vena Cava ◽  
Inferior Vena Cava Thrombus

scholarly journals Surgical treatment of patients with renal cell cancer complicated by specific (tumor) and non-specific thrombosis of the inferior Vena cava

2020 ◽  
Vol 7 (3) ◽  
pp. 91-98
Author(s):  
N. V. Vorobev ◽  
F. S. Ashyrova ◽  
M. P. Golovashchenko ◽  
L. O. Petrov ◽  
A. D. Kaprin
Keyword(s):  
Renal Cell Carcinoma ◽  
Surgical Treatment ◽  
Inferior Vena Cava ◽  
Cell Carcinoma ◽  
Kidney Cancer ◽  
Renal Cell ◽  
Inferior Vena ◽  
Cell Cancer ◽  
Vena Cava ◽  
Specific Tumor

Among malignant neoplasms, kidney cancer occupies one of the first places in terms of the growth rate of incidence in Russia. Despite the possibilities of modern diagnostic research methods, the number of patients with common forms of the disease does not decrease. In 5–10% of cases, renal cell carcinoma is complicated by the formation of a tumor clot in the inferior Vena cava (VCI), which requires volume surgery — nephrectomy with thrombectomy, which is the only effective treatment option for this group of patients. Previously, the results of treatment of locally advanced kidney cancer were unsatisfactory due to the high incidence of complications and mortality after extended surgical interventions. However, improving the operation technique requires a re-evaluation of previous representations. Performing a nephrectomy with a VCI thrombectomy is not an easy task and is often associated not only with technical difficulties due to the need for mobilization, control and resection of the inferior Vena cava, but also with the risk of intra — and postoperative complications. The most difficult task is the choice of surgical tactics for descending non-tumor hemorrhagic thrombosis. As a result of long-term tumor obstruction, organized blood clots that are soldered to the intima of the vessel often spread to the common iliac veins and, as a rule, are technically impossible to remove. If the VCI is preserved, a residual hemorrhagic blood clot in the area of its confluence is a potential source of pulmonary embolism (PE), for the prevention of which mechanical plication is used. This maneuver does not lead to the development of clinically significant chronic venous insufficiency of the lower extremities (CVI NC), postoperative VCI or PE thrombosis. Despite the technical complexity of the operation and the difficult course of the postoperative period, surgical treatment of renal cell cancer complicated by tumor thrombosis is certainly justified. This article presents a clinical case of surgical treatment of a patient with renal cell cancer complicated by massive specific (tumor) and non-specific thrombosis in the presence of reduced parenchymalexcretory function of the contralateral kidney and severe cardiac pathology. Goal: to share experience and demonstrate the results of successful surgical treatment of renal cell carcinoma.

scholarly journals Surgical treatment of renal cell carcinoma with advanced tumor invasion of the inferior vena cava

2017 ◽  
Vol 13 (1) ◽  
pp. 27-36 ◽  
Author(s):  
M. I. Davydov ◽  
V. B. Matveev ◽  
M. I. Volkova ◽  
A. K. Begaliev ◽  
P. I. Feoktistov ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Surgical Treatment ◽  
Inferior Vena Cava ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Tumor Invasion ◽  
Inferior Vena ◽  
Vena Cava ◽  
Advanced Tumor

scholarly journals Selective Upper-Body Perfusion Technique for Removal of Renal Cell Carcinoma Extending into the Inferior Vena Cava and Right Atrium

2017 ◽  
Vol 44 (4) ◽  
pp. 283-286
Author(s):  
Selim Aydin ◽  
Bora Cengiz ◽  
Banu Vural Gokay ◽  
Anar Mammadov ◽  
Remzi Emiroglu ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Inferior Vena Cava ◽  
Cell Carcinoma ◽  
Right Atrium ◽  
Renal Cell ◽  
Inferior Vena ◽  
Vena Cava ◽  
Upper Body ◽  
Surgical Field ◽  
The Right

Invasion of a renal cell carcinoma thrombus into the inferior vena cava and right atrium is infrequent. Reaching and completely excising a tumor from the inferior vena cava is particularly challenging because the liver covers the surgical field. We report the case of a 61-year-old man who underwent surgery for a renal cell carcinoma of the right kidney that extended into the inferior vena cava and right atrium. During dissection of the liver to expose the inferior vena cava, transesophageal echocardiograms revealed right atrial mass migration into the tricuspid valve. On emergency sternotomy, the tumor embolized into the main pulmonary artery. We used a selective upper-body perfusion technique involving moderately hypothermic cardiopulmonary bypass, cardioplegic arrest, and clamping of the descending aorta, which provided a bloodless surgical field for precise removal of the mass and resulted in minimal blood loss. Our technique might be useful in other patients with tumor thrombus extending into the right atrium because it reduces the need for transfusion and avoids the deleterious effects of deep hypothermic circulatory arrest. Our case also illustrates the importance of continuous transesophageal echocardiographic monitoring to detect thrombus embolization.

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