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< Vol. 82 Issue 4 | Oct-Dec 2015 | pp. 193 - 246

Surgical treatment of renal carcinoma with atrial tumor thrombus avoiding cardiopulmonary bypass: step-by-step description

Abstract

Tumor thrombus in the inferior vena cava (IVC) occurs in 4-10% of patients with renal cell carcinoma (RCC) and poses a challenge for the surgical team. Because there is no systemic therapy available to significantly reduce tumor burden, surgical intervention is the only treatment. However, the surgical approach is associated with significant morbidity and mortality. When the thrombus extends above the diaphragm, the use of cardiopulmonary bypass (CPB) and accompanying deep hypothermic circulatory arrest (DHCA) has usually been advocated. However, complications inherent to CPB and DHCA, such as coagulopathy and central nervous system complications, have led us to search for an alternative surgical approach to these tumors. The purpose of this study is to describe the surgical technique used in five patients with large RCC with tumor thrombus extending into the supradiaphragmatic IVC and Right atrium (RA), Right atrium, who underwent extensive resection without CPB and DHCA.

Urologia 2015; 82(4): 223 - 225

Article Type: ORIGINAL RESEARCH ARTICLE

DOI:10.5301/uro.5000126

Authors

Nicola Guglielmo, Fabio Melandro, Gioacchino Montalto, Luca Poli, Fatima Della Pietra, Massimo Rossi, Giuseppe Mazzesi, Pasquale Berloco

Article History

  • • Accepted on 07/05/2015
  • • Available online on 10/06/2015
  • • Published in print on 02/12/2015

Disclosures

Financial support: The authors declare that they have no sources of funding for this study.
Conflicts of interest: The authors have no conflicts of interest.

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Authors

Affiliations

  • Department of General Surgery and Human Organs Transplant. “Sapienza” University of Rome - Italy

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