Article

Renal cell carcinoma invading the inferior vena cava: use of a "temporary" vena cava filter to prevent tumor emboli during nephrectomy.

Department of Vascular Surgery, Atlanta Medical Center, Atlanta, Georgia 30312, USA.
Urology (impact factor: 2.43). 03/2004; 63(2):380-2. DOI:10.1016/j.urology.2003.10.010 pp.380-2
Source: PubMed

ABSTRACT Renal cell carcinoma with tumor thrombus extension into the inferior vena cava (IVC) remains a difficult operative challenge. Placement of a suprarenal "temporary" IVC filter, with its ease of insertion and removal, makes it the ideal treatment to prevent pulmonary embolism in these difficult cases. We report the first 2 cases of temporary suprarenal IVC filters placed at the time of radical nephrectomy to eliminate the possibility of perioperative pulmonary embolus and avoid the potential long-term sequelae of a permanent suprarenal IVC filter.

0 0
 · 
0 Bookmarks
 · 
19 Views
  • Source
    Article: Surgical treatment of malignant involvement of the inferior vena cava.
    Patrizio Castelli, Roberto Caronno, Gabriele Piffaretti, Matteo Tozzi, Chiara Lomazzi, Gianlorenzo Dionigi, Luigi Boni, Renzo Dionigi
    [show abstract] [hide abstract]
    ABSTRACT: Resection and replacement of the inferior vena cava to remove malignant disease is a formidable procedure. The purpose of this review is to describe our experience with regard to patient selection, operative technique, and early and late outcome. The authors retrospectively reviewed a 12-year series of 11 patients; there were 10 males, with a mean age 57 +/- 13 years (range 27-72) who underwent caval thrombectomy and/or resection for primary (n = 9) or recurrent (n = 2) vena cava tumours. Tumour location and type, clinical presentation, the segment of vena cava treated, graft patency, and tumour recurrence and survival data were collected. Late follow-up data were available for all patients. Graft patency was determined before hospital discharge and in follow-up by CT scan or ultrasonography. More than 80% of patients had symptoms from their caval involvement. The most common pathologic diagnosis was renal cell carcinoma (n = 6), and hepatocarcinoma (n = 2). In all but 2 patients, inferior vena cava surgical treatment was associated with multivisceral resection, including extended nephrectomy (n = 5), resection of neoplastic mass (n = 3), major hepatic resection (n = 2), and adrenal gland resection (n = 1). Prosthetic repair was performed in 5 patients (45%). There were no early deaths. Major complications occurred in 1 patient (9%). Mean length of stay was 16 days. Late graft thrombosis or infection did not occur. The mean follow-up was 22.7 months (range 6-60). There have been no other late graft-related complications. All late deaths were caused by the progression of malignant disease and the actuarial survival rate was 100% at 1 year. Mean survival was 31 months (median 15). Aggressive surgical management may offer the only chance for cure or palliation for patients with primary or secondary caval tumours. Our experience confirms that vena cava surgery for tumours may be performed safely with low graft-related morbidity and good patency in carefully selected patients.
    International Seminars in Surgical Oncology 02/2006; 3:19.
Data provided are for informational purposes only. Although carefully collected, accuracy cannot be guaranteed. The impact factor represents a rough estimation of the journal's impact factor and does not reflect the actual current impact factor. Publisher conditions are provided by RoMEO. Differing provisions from the publisher's actual policy or licence agreement may be applicable.

Keywords

difficult cases
 
first 2 cases
 
ideal treatment
 
inferior vena cava
 
insertion
 
perioperative pulmonary embolus
 
pulmonary embolism
 
radical nephrectomy
 
Renal cell carcinoma
 
temporary
 
temporary suprarenal IVC filters
 

Eric Wellons