Inferior vena cava resection and reconstruction: Technical considerations in the surgical management of renal cell carcinoma with tumor thrombus

Abstract The mainstay of treatment for renal cell carcinoma with invasion of the inferior vena cava (IVC) is complete surgical extirpation. Cases complicated by adherent or invasive tumor thrombus represent a special technical challenge due to the need for resection of a large segment of the IVC. Th...

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Bibliographic Details
Published in:Urologic oncology 2014, Vol.32 (1), p.34.e19-34.e26
Main Authors: González, Javier, M.D, Gorin, Michael A., M.D, Garcia-Roig, Michael, M.D, Ciancio, Gaetano, M.D
Format: Article
Language:English
Subjects:
Carcinoma, Renal Cell - surgery
Hemodynamics
Humans
Image Processing, Computer-Assisted
Inferior vena cava
Kidney - surgery
Kidney Neoplasms - surgery
Models, Anatomic
Neoplasm Invasiveness
Nephrectomy - methods
Reconstruction
Reconstructive Surgical Procedures - methods
Renal cell carcinoma
Renal Veins - surgery
Resection
Surgical Procedures, Operative
Thrombectomy - methods
Thrombosis - pathology
Thrombosis - surgery
Treatment Outcome
Tumor thrombus
Urology
Vena Cava, Inferior - surgery
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Summary:Abstract The mainstay of treatment for renal cell carcinoma with invasion of the inferior vena cava (IVC) is complete surgical extirpation. Cases complicated by adherent or invasive tumor thrombus represent a special technical challenge due to the need for resection of a large segment of the IVC. The aim of this review is to describe the indications and surgical approach for radical nephrectomy with en bloc resection of the IVC with or without venous reconstruction. In addition, special attention is paid to the relevant anatomical and hemodynamic considerations related to the development of venous collateral pathways secondary to IVC obstruction.
ISSN:1078-1439
1873-2496
DOI:10.1016/j.urolonc.2013.01.004