Radical nephrectomy and vena cava inferior thrombectomy for renal cell cancer

Written by Szendrői Attila, Nagy Zoltán, Pánovics József, Harsányi László, Szűcs Miklós, Romics Imre

Aim: To evaluate the data of patients treated at our department for renal cell cancer combined with tumor thrombus of the inferior vena cava. Material and methods: Twelve patients underwent surgery for renal cell cancer combined with tumor thrombus of inferior vena cava between 1998 and 2005 at the Department of Urology, Semmelweis University. The preoperative symptoms, types of surgical interventions, TNM classification of the tumors and the postoperative management are demonstrated on detailed tables. Results: The mean diameter of the tumors was 98 mm, the length of cava thrombus was 58 mm, and histology showed conventional clear cell cancer in 9 patients. The average operation time was 4 hours 3 minutes, the clamping time of the cava was 14 minutes. Blood loss was 1300 ml, wich was compensated with 4,3 units of blood cell concentrate. The intraoperative complications were: 2 times unsignificant bleeding from the cava, 1 injury of the ureter, and 1 of the liver, 2 times intraoperative sudden death. Six of our patients are still alive, and 4 died, their average survival time was 26.5 months postoperatively. Conclusion: The cooperation between urologist and vascular surgent in the management of these high risk patient not only make surgical treatment successful, but can also prolong the survival.

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