Format

Send to

Choose Destination
See comment in PubMed Commons below
J Cardiothorac Surg. 2010 Nov 5;5:103. doi: 10.1186/1749-8090-5-103.

Surgical resection of a renal cell carcinoma involving the inferior vena cava: the role of the cardiothoracic surgeon.

Author information

1
Royal Victoria Hospital, Grosvernor Rd, Belfast, BT12 6BA, Northern Ireland. hparissis@yahoo.co.uk

Abstract

BACKGROUND:

The techniques for the resection of renal tumors with IVC extension are based on the experience of individual units. We attempt to provide a logical approach of the surgical strategies in a stepwise fashion.

METHODS:

Over 6-years 9 patients with renal cell carcinoma invading the IVC, underwent surgery. There were 6 males. The extension was at level IV in 4 and III in 5 cases. CPB used in 8 and hypothermia and circulatory arrest in all patients with level IV disease. The results and an algorithm of the plan of action, as per level of extension are presented.

RESULTS:

Plan of action: For level I-II disease: No Cardiothoracic involvement, For level III: Cardiopulmonary Bypass (CPB) & control of the cavo-atrial junction. For level IV: use of brief periods of Circulatory Arrest & repair of the Cavotomy with a pericardial patch. Postoperative morbidity: prolonged ICU stay, 3 patients (33.3%); tracheostomy, 1 (11.1%); Sepsis, 2 (22.2%); CVA 1, (11.1%). Mortality: 2 patients (22.2%)

CONCLUSIONS:

Total clearance of the IVC from an adherent tumor is important, therefore extensive level IV disease presents a surgical challenge.We recommend CPB for level III and brief periods of Total Circulatory Arrest (TCA) for level IV disease.

PMID:
21054828
PMCID:
PMC2989311
DOI:
10.1186/1749-8090-5-103
[Indexed for MEDLINE]
Free PMC Article
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for BioMed Central Icon for PubMed Central
    Loading ...
    Support Center