Endoluminal Control of the Inferior Vena Cava During Resection of a Level III Tumor Thrombus Associated With Renal Cell Carcinoma: A Case Report and Review of the Literature
Restricted accessReview articleFirst published online August, 2010
Endoluminal Control of the Inferior Vena Cava During Resection of a Level III Tumor Thrombus Associated With Renal Cell Carcinoma: A Case Report and Review of the Literature
Removal of tumor thrombus in the inferior vena cava (IVC) associated with renal cell carcinoma (RCC) presents a surgical challenge. Traditional techniques for vena caval control and thrombectomy for level III and IV thrombi require considerable added surgical morbidity. We present a case employing an endoluminal approach using balloon occlusion for vascular control and subsequent tumor resection. We also review other minimally invasive techniques described recently in the literature and compare these techniques with our own.
Wotkowicz C. , Wszolek MF, Libertino JAResection of renal tumors invading the vena cava. Urol Clin North Am. 2008; 35(4):657-671, viii.
2.
Jibiki M., Iwai T., Inoue Y., et al. Surgical strategy for treating renal cell carcinoma with thrombus extending into the inferior vena cava. J Vasc Surg. 2004;39(4):829-835.
3.
Ayati M., Nikfallah A., Jabalameli P., Najjaran Tousi V., Noroozi M., Jamshidian H.Extensive surgical management for renal tumors with inferior vena cava thrombus . Urol J. 2006; 3(4):212-215.
4.
Sweeney P., Wood CG, Pisters LL, et al. Surgical management of renal cell carcinoma associated with complex inferior vena caval thrombi. Urol Oncol. 2003;21(5):327-333.
5.
Rigberg DA, Jimenez JC, Lawrence PF. Balloon control of the suprahepatic inferior vena cava: a novel technique for renal cell carcinoma tumor thrombus. Ann Vasc Surg. 2008;22(2):200-202. 6. Zini L, Koussa M, Haulon S, et al. Results of endoluminal occlusion of the inferior vena cava during radical nephrectomy and thrombectomy. Eur Urol. 2008;54(4):778-783.
6.
Yang Y., Sun S., Xiao X., et al. Temporary balloon occlusion of inferior vena cava in resection of renal tumor with vena cava thrombus extension. Urology . 2009;73(3):645-648.
7.
Taweemonkongsap T., Nualyong C., Leewansangtong S., et al. Surgical treatment of renal cell carcinoma with inferior vena cava thrombus: using liver mobilization technique to avoid cardiopulmonary bypass. Asian J Surg. 2008;31(2):75-82.
8.
Ciancio G., Vaidya A., Savoie M., Soloway M.Management of renal cell carcinoma with level III thrombus in the inferior vena cava. J Urol. 2002;168(4 pt 1):1374-1377.
9.
Gallucci M. , Borzomati D., Flammia G., et al. Liver harvesting surgical technique for the treatment of retro-hepatic caval thrombosis concomitant to renal cell carcinoma: perioperative and long-term results in 15 patients without mortality . Eur Urol. 2004;45(2): 194-202.
10.
Wang GJ, Carpenter JP, Fairman RM, et al. Single-center experience of caval thrombectomy in patients with renal cell carcinoma with tumor thrombus extension into the inferior vena cava. Vasc Endovasc Surg. 2008;42(4):335-340.