A novel technique for avoidance of sternotomy, diaphragmic incision and cardiopulmonary bypass during cavoatrial tumor thrombectomy for renal cell carcinoma with intraatrial tumor thrombus: a case series at a single center.
BMC Surg
; 23(1): 252, 2023 Aug 24.
Article
em En
| MEDLINE
| ID: mdl-37620830
ABSTRACT
BACKGROUND:
Radical nephrectomy with thrombectomy in patients with renal cell carcinoma (RCC) and level IV thrombus extending to the right atrium (RA) offers improved survival. However, this procedure is associated with significant perioperative morbidity and mortality. In this report, we describe a novel milking technique for patients with RA tumor thrombus using abdominal access, which does not require diaphragmic incision, sternotomy, right atriotomy, or cardiopulmonary bypass (CPB).METHODS:
Between January 2019 and January 2022, four patients underwent resection of renal cell carcinoma extending into RA by a milking technique developed to avoid diaphragmic incision, sternotomy, or CPB. Patient characteristics, perioperative data, pathological features, and survival were evaluated.RESULTS:
Complete resection was successful through pure transabdominal access without diaphragmic incision, sternotomy, or CPB in all patients.CONCLUSION:
We conclude that radical nephrectomy and thrombectomy in optimized cases with renal cell carcinoma extending into RA can be safely and effectively performed without diaphragmic incision, sternotomy, or CPB, avoiding serious perioperative complications while providing acceptable oncological outcomes.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Trombose
/
Carcinoma de Células Renais
/
Neoplasias Renais
Tipo de estudo:
Etiology_studies
Limite:
Humans
Idioma:
En
Revista:
BMC Surg
Ano de publicação:
2023
Tipo de documento:
Article