Risk factors for acute kidney injury after radical nephrectomy and inferior vena cava thrombectomy for renal cell carcinoma

511 Background: Local recurrence after radical nephrectomy in renal cell carcinoma occurs in about 2-4% of the patients. An isolated intracaval thrombus is described in only very few cases. We report about our experience in the diagnosis and theapy of this random entity. Methods: 5 patients (2f, 3m) were referred to our institution with the diagnosis of an IVC thrombus recurrence. All patients had underwent a radical nephrectomy 1-9 years before the relapse. In 3 patients, the thrombus was diagnosed within the routine follow up, another 2 presented with swelling/deep vein thrombosis. The staging showed no other metastases. Results: The mean patient age at time of diagnosis was 73.8 (70-81) years. 2 patients presented with a level II thrombus, 2 with level III and one with a level IV thrombus. We could resect the thrombus completely in 4 cases and close the cava with a running suture. In one case we had to resect the inferior vena cava completely and replace it with a gortex prosthesis. The mean blood loss was 1.7 (0-8) liters at an operating time of 5.5 (4.3-7.6) hours. The mean follow up was 3.5 (0.5-8) years, until today occured one case of pulmonal metastatic disease. Significant perioperative complications classified after Clavien-Dindo occured in one case with an intraoperative bleeding and rupture oft he spleen that required a mass-transfusion. Conclusions: Although it is a technical demanding procedure, the surgical resection of a recurrent vena cava thrombus is the method of choice with only a little perioperative morbidity and high oncological effectivity. This random type of recurrent disease illustrates the importance of an adequate primary therapy as well as a regularly follow up after cava-involvement.

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Surgical resection of recurrent inferior vena cava tumor following radical nephrectomy for renal cell carcinoma: A case report

Oncology Letters ◽

10.3892/ol.2015.3187 ◽

2015 ◽

Vol 10 (1) ◽

pp. 111-114 ◽

Cited By ~ 1

Author(s):

GUANGYUAN LI ◽

ZHIQIANG ZHANG ◽

DONGDONG XIE ◽

NAN YE ◽

DEXIN YU

Keyword(s):

Renal Cell Carcinoma ◽

Case Report ◽

Inferior Vena Cava ◽

Cell Carcinoma ◽

Surgical Resection ◽

Renal Cell ◽

Radical Nephrectomy ◽

Inferior Vena ◽

Vena Cava

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Resection of recurrent inferior vena cava tumor after radical nephrectomy for renal cell carcinoma

Urology ◽

10.1016/j.urology.2005.10.058 ◽

2006 ◽

Vol 67 (5) ◽

pp. 1084.e5-1084.e7 ◽

Cited By ~ 7

Author(s):

Marc C. Smaldone ◽

Glenn M. Cannon ◽

Ronald L. Hrebinko

Keyword(s):

Renal Cell Carcinoma ◽

Inferior Vena Cava ◽

Cell Carcinoma ◽

Renal Cell ◽

Radical Nephrectomy ◽

Inferior Vena ◽

Vena Cava

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Tempofilter II for tumor emboli prevention during radical nephrectomy and inferior vena cava thrombus resection for renal cell carcinoma

Journal of Surgical Oncology ◽

10.1002/jso.21303 ◽

2009 ◽

Vol 100 (2) ◽

pp. 159-162 ◽

Cited By ~ 14

Author(s):

Xiang Feng ◽

Junmin Bao ◽

Zaiping Jing ◽

Jianguo Hou ◽

Xu Gao

Keyword(s):

Renal Cell Carcinoma ◽

Inferior Vena Cava ◽

Cell Carcinoma ◽

Renal Cell ◽

Radical Nephrectomy ◽

Inferior Vena ◽

Vena Cava ◽

Inferior Vena Cava Thrombus ◽

Tumor Emboli

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Risk factors for acute kidney injury after unilateral radical nephrectomy and inferior vena cava thrombectomy under cardiopulmonary bypass: a retrospective study

10.21203/rs.3.rs-381926/v1 ◽

2021 ◽

Author(s):

Qi Zhang ◽

Ming Li ◽

Dongmei Fu ◽

Dongxin Wang ◽

Shiqi Diao

Keyword(s):

Risk Factors ◽

Acute Kidney Injury ◽

Retrospective Study ◽

Cardiopulmonary Bypass ◽

Inferior Vena Cava ◽

Radical Nephrectomy ◽

Inferior Vena ◽

Vena Cava ◽

Kidney Injury ◽

Postoperative Aki

Abstract In patients with renal cell carcinoma (RCC) and cancer-related thrombosis in the inferior vena cava (IVC) or right atrium (AT), it is still unknown whether nephrectomy, anesthesia, and surgical trauma can cause postoperative acute kidney injury (AKI) and what are the risk factors for AKI. To examine the incidence and risk factors of postoperative AKI in patients who underwent unilateral radical nephrectomy and cardiopulmonary bypass (CPB)-assisted thrombectomy in the IVC and/or atrial AT due to RCC complicated with cancer-associated thrombosis. This retrospective study included patients who underwent unilateral radical nephrectomy and CPB-assisted thrombectomy in the inferior vena cava and/or atrial pulmonary artery due to RCC, under general anesthesia, from December 2011 to June 2015, at Peking University First Hospital. Among 31 patients, 15 (48.4%) had postoperative AKI. Compared with the non-AKI group (n = 16), patients in the AKI group (n = 15) were older (59.0 ± 8.7 vs. 48.5 ± 12.9 years, P = 0.012) had smaller intraoperative urine volume (1225 ± 639 vs. 1685 ± 597 mL, P = 0.048). There were no differences in preoperative creatinine clearance. Age (OR = 1.10, 95%CI: 1.02–1.20, P = 0.020) was independently associated with AKI occurrence. The patients undergoing unilateral radical nephrectomy and CPB-assisted IVC thrombectomy have a high rate of AKI. Older ones are at a higher risk of postoperative AKI.

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