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Surgical Management of Renal Cell Carcinoma with Vena Caval Extension

Case Reports

3rd Department of Surgery, 2nd Faculty of Medicine; City Hospital, Warsaw, Poland

Andrzej Borkowski, MD

Department of Urology, Warsaw Medical School; City Hospital, Warsaw, Poland

Waclaw Sitkowski, MD

Boleslaw Kuzaka, MD

2nd Department of Cardiac Surgery, Institute of Cardiology, Warsaw; City Hospital, Warsaw, Poland

Maciej Kisiel, MD

3rd Department of Surgery, 2nd Faculty of Medicine; City Hospital, Warsaw, Poland

Andrzej Kidawa, MD

Urology Unit; City Hospital, Warsaw, Poland

Zbigniew Biejat, MD

3rd Department of Surgery, 2nd Faculty of Medicine; City Hospital, Warsaw, Poland

Retrohepatic vena cava surgery was performed in nine patients with renal cell carcinoma and with a propagation of the neoplastic thrombus into the inferior vena cava (IVC) up to the confluence with hepatic veins or to the right heart. Surgical treatment consisted of simultaneous radical nephrectomy and exploration of the retrohepatic vena cava with careful removal under direct vision of the thrombus, which was attached to the intima. In two patients cardiopulmonary bypass was used. All procedures were performed under IVC exclusion. Five patients are still alive from 2 up to 48 months after surgery. Surgical technique and postoperative management including vascular complications are discussed.

Vascular and Endovascular Surgery, Vol. 34, No. 6, 577-581 (2000)
DOI: 10.1177/153857440003400612


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