Resection of the Suprarenal Inferior Vena Cava for Retroperitoneal Malignant Disease

Abstract

Minimal renal dysfunction was noted in 4 of 5 patients undergoing right nephrectomy with resection of the inferior vena cava and ligation of the left renal vein. However, the results of this series confirm previous reports that patients with locally advanced right renal carcinoma requiring vena caval resection are cured rarely by an operation alone. In the absence of effective adjunctive therapy for renal cell carcinoma this procedure will most likely benefit patients with neoplasms responsive to either chemotherapy or radiation therapy.

A cut above? Inferior vena cava resection without reconstruction: a dual-centre experience

“…Inferior vena cava (IVC) extension has presented a surgical challenge for resection of renal cell cancer (RCC) and adrenal cancer, and involvement of the cava was associated with a poorer prognosis. 1 However, with advancing surgical techniques which increased the ability to be more aggressive in a radical resection, it became clearer that it was not the presence of intracaval extension, but whether any residual tumour was left, that influenced outcomes. 2,3 Intracaval tumour thrombectomy has been a longestablished practice, but tumour adherent to the caval wall presented challenges to completely resect, with associated risks of residual tumour and/or embolisation from this.…”

“…The strategies involved with excision of an affected segment of VC have turned full circle, since the earliest reports in the 1950s and 1960s. 5–8 These reports describe resection of the involved caval segment without graft reconstruction which was the general approach 1,2 until the first report of reconstruction using a polytetrafluoroethylene (PTFE) graft in 1984. 9 This technique of reconstruction was popularised and widely published in urological literature.…”

Nierenkarzinom mit Kavatumorthrombus - radikale Nephrektomie mit extrakorporalem Kreislauf

“…Beim Nierenkarzinom mit Tumorinvasion in die untere Hohlvene ist -sofern Fernmetastasen nicht nachweisbar sind -radikal chirurgisches Vorgehen berechtigt (1,2,3,13,14,15,18,19). Ohne operative Therapie ist eine längere Überlebenszeit die Ausnahme (7), Exitus innerhalb eines Jahres an Tumorembolie oder generalisierter Metastasierung die Regel.…”