scholarly journals Antegrade balloon occlusion of inferior vena cava during thrombectomy for renal cell carcinoma

2013 ◽  
Vol 4 (4) ◽  
pp. 105 ◽  
Author(s):  
Charles Metcalfe ◽  
Laura Chang-Kit ◽  
Ioana Dumitru ◽  
Shaun MacDonald ◽  
Peter Black
Keyword(s):  
Renal Cell Carcinoma ◽  
Inferior Vena Cava ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Inferior Vena ◽  
Vena Cava ◽  
Balloon Occlusion ◽  
Occlusion Time ◽  
Tumour Thrombus ◽  
Tumour Extension

Nephrectomy with inferior vena cava (IVC) thrombectomy foradvanced renal cell carcinoma (RCC) is a challenging and morbidsurgical case. We describe the use of a simple endoluminaltechnique to occlude the suprahepatic IVC during thrombectomy.A 60-year-old male presented with a large right-sided RCC andIVC tumour thrombus. The tip of the thrombus, which was nonadherentto the caval wall, extended to the level of the hepaticveins. After complete dissection of the kidney, we obtained suprahepaticcontrol of the IVC by a large compliant balloon, introducedthrough the right internal jugular vein and inflated just below thelevel of the diaphragm. The IVC thrombectomy was performedin a bloodless field. Mean blood pressure remained stable duringIVC balloon inflation with a total occlusion time of 10 minutes.Intraprocedural completion cavogram and postoperative Dopplerultrasonography showed no residual IVC clot. Blood loss duringthe thrombectomy portion of the case was scant. The patient’spostoperative course was uncomplicated and, at the last followup,he had stable metastatic disease on sunitinib therapy. For thesurgical treatment of RCC with retrohepatic IVC tumour extension,transjugular balloon occlusion of the suprahepatic IVC offers analternative to extensive hepatic mobilization to obtain suprahepaticthrombus control. Advantages over traditional surgical methodsmay include decreased surgical time, lower risk of liver injury andtumour embolism. We suggest this method for further evaluation.

scholarly journals Robust response to nivolumab in patient with renal cell carcinoma inferior vena cava tumour thrombus

2019 ◽  
Vol 12 (4) ◽  
pp. e227030 ◽  
Author(s):  
Joel Berends ◽  
Eric Gourley ◽  
Dharam Kaushik
Keyword(s):  
Renal Cell Carcinoma ◽  
Inferior Vena Cava ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Inferior Vena ◽  
Vena Cava ◽  
Distant Metastases ◽  
Molecular Therapy ◽  
Tumour Thrombus ◽  
Robust Response

A 47-year-old previously healthy man presented with acute moderate flank pain. Evaluation revealed left renal cell carcinoma, with inferior vena cava tumour thrombus invasion. Patient had no significant history or risk factors to pre-dispose him to genitourinary cancers. Surgery was deemed to not be appropriate due to distant metastases, but patient received targeted molecular therapy and immunotherapy with striking regression of the thrombus.

Renal cell carcinoma and tumour thrombus in the inferior vena cava: clinical outcome of 98 consecutive patients and the prognostic value of preoperative parameters

2014 ◽  
Vol 33 (10) ◽  
pp. 1541-1552 ◽  
Author(s):  
Christian Niedworok ◽  
Bettina Dörrenhaus ◽  
Frank vom Dorp ◽  
Jarowit Adam Piotrowski ◽  
Stephan Tschirdewahn ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Clinical Outcome ◽  
Inferior Vena Cava ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Prognostic Value ◽  
Inferior Vena ◽  
Vena Cava ◽  
Tumour Thrombus

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.

Important surgical considerations in the management of renal cell carcinoma (RCC) with inferior vena cava (IVC) tumour thrombus

2012 ◽  
Vol 110 (7) ◽  
pp. 926-939 ◽  
Author(s):  
Samuel M. Lawindy ◽  
Tony Kurian ◽  
Timothy Kim ◽  
Devanand Mangar ◽  
Paul A. Armstrong ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Inferior Vena Cava ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Inferior Vena ◽  
Vena Cava ◽  
Tumour Thrombus

scholarly journals Inferior vena cava tumour thrombus and renal cell carcinoma

2017 ◽  
Vol 65 (5) ◽  
pp. 588-589
Author(s):  
David W. Barbara ◽  
Stephen M. Broski ◽  
Bradley C. Leibovich ◽  
William J. Mauermann
Keyword(s):  
Renal Cell Carcinoma ◽  
Inferior Vena Cava ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Inferior Vena ◽  
Vena Cava ◽  
Tumour Thrombus
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