Complete ablation of a renal tumor abutting the inferior vena cava using a radiofrequency electrode as a lever: A case report

2009 ◽  
Vol 50 (2) ◽  
pp. 238-240 ◽  
Author(s):  
Byung Kwan Park ◽  
Chan Kyo Kim
Keyword(s):  
Radiofrequency Ablation ◽  
Inferior Vena Cava ◽  
Vascular Injury ◽  
Inferior Vena ◽  
Renal Tumor ◽  
Vena Cava ◽  
Renal Tumors ◽  
Invasive Treatment ◽  
Sink Effect ◽  
Large Vessels

Radiofrequency ablation is accepted as a minimally invasive treatment for renal tumors in patients who are poor candidates for surgery. However, ablation of tumors that abut large vessels is likely to be incomplete due to the heat-sink effect or may result in vascular injury. We report a case of a renal tumor abutting the inferior vena cava, which was successfully treated with radiofrequency ablation, with an emphasis on the technical aspects required to avoid both incomplete ablation and vascular injury by using a radiofrequency electrode as a lever.

scholarly journals A case of Wilms tumor with right ventricular extension of tumor thrombus

2017 ◽  
Vol 4 (1) ◽  
pp. 60
Author(s):  
Mustafa Çakan ◽  
Ayşe Gülnur Tokuç ◽  
Kıvılcım Karadeniz Cerit ◽  
Koray Ak ◽  
Rabia Ergelen
Keyword(s):  
Inferior Vena Cava ◽  
Right Ventricle ◽  
Right Atrium ◽  
Tumor Thrombus ◽  
Inferior Vena ◽  
Renal Tumor ◽  
Wilms Tumor ◽  
Vena Cava ◽  
Renal Tumors ◽  
Tumor Extension

Primary renal tumors comprise 6% of all childhood cancers. Wilms tumor is the most common primary renal tumor in pediatric age group and the peak age of diagnosis is 3-4 years. In 10% of cases tumor extension into hepatic vein and inferior vena cava can be seen. But tumor extension into whole inferior vena cava, right atrium and right ventricle is only seen in less than 1% of patients. A 2-year-old girl was admitted to the hospital because of abdominal distension that was noticed by the parents two weeks ago. Imaging studies revealed that she had a mass at the right renal lodge which was favoring to Wilms tumor and on thorax tomography tumor thrombus was seen in the whole inferior vena cava, right atrium and right ventricle. Neoadjuvant chemotherapy was given for 7 weeks. On the 8th week of diagnosis, under cardiopulmonary bypass, surgical operation by pediatric and cardiovascular surgery teams for primary renal tumor and for cavo-atrial tumor thrombus was performed. Pathological examination of the mass was reported as stage 3 diffuse anaplastic Wilms tumor. The patient completed 24 weeks of chemotherapy protocol and she is being followed for 15 months without any morbidity. We present our case to emphasize the importance of multidisciplinary approach in Wilms tumor with cardiac extension.

Transabdominal Surgical Approach in the Management of Renal Tumors Involving the Retrohepatic Inferior Vena Cava

2000 ◽  
Vol 14 (5) ◽  
pp. 436-443 ◽  
Author(s):  
Jose A. Gonzalez-Fajardo ◽  
Ernesto Fernandez ◽  
Jesús Rivera ◽  
Alejandro Pelaz ◽  
Javier Gonzalez-Zarate ◽  
...  
Keyword(s):  
Inferior Vena Cava ◽  
Surgical Approach ◽  
Inferior Vena ◽  
Vena Cava ◽  
Renal Tumors ◽  
Retrohepatic Inferior Vena Cava

scholarly journals Combination of Superselective Arterial Embolization and Radiofrequency Ablation for the Treatment of a Giant Renal Angiomyolipoma Complicated with Caval Thrombus

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Konstantinos N. Stamatiou ◽  
Hippocrates Moschouris ◽  
Kiriaki Marmaridou ◽  
Michail Kiltenis ◽  
Konstantinos Kladis-Kalentzis ◽  
...  
Keyword(s):  
Radiofrequency Ablation ◽  
Inferior Vena Cava ◽  
Inferior Vena ◽  
Transarterial Embolization ◽  
Vena Cava ◽  
Arterial Embolization ◽  
Maximum Diameter ◽  
Renal Angiomyolipoma ◽  
Efficient Treatment ◽  
Extrinsic Compression

This is a case of a 78-year-old male patient with multiple angiomyolipomas of a solitary right kidney. The largest of these tumors (maximum diameter: 13.4 cm) caused significant extrinsic compression of the inferior vena cava complicated by thrombosis of this vessel. Treatment of thrombosis with anticoagulants had been ineffective and the patient had experienced a bleeding episode from the largest right renal angiomyolipoma, which had been treated by transarterial embolization in another institution, 4 months prior to our intervention. Our approach included superselective transarterial embolization of the dominant, right kidney angiomyolipoma with hydrogel microspheres, which was combined, 20 days later, with ultrasonographically guided radiofrequency ablation. Both interventions were uneventful. Computed tomography 2 months after ablation showed a 53% reduction in tumor volume, reduced space-occupying effect on inferior vena cava, and resolution of caval thrombus. Nine months after intervention the patient has had no recurrence of thrombosis or hemorrhage and no tumor regrowth has been observed. The combination of superselective transarterial embolization and radiofrequency ablation seems to be a feasible, safe, and efficient treatment of large renal angiomyolipomas.

Malignant renal tumor with extension to the inferior vena cava

1998 ◽  
Vol 176 (2) ◽  
pp. 137-139 ◽  
Author(s):  
Sateesh C. Babu ◽  
Tim Mianoni ◽  
Pravin M. Shah ◽  
Arun Goyal ◽  
Muhammad Choudhury ◽  
...  
Keyword(s):  
Inferior Vena Cava ◽  
Inferior Vena ◽  
Renal Tumor ◽  
Vena Cava ◽  
Malignant Renal Tumor

Contemporary Management and Outcomes of Injuries to the Inferior Vena Cava: A Prospective Multicenter Trial From PROspective Observational Vascular Injury Treatment

2021 ◽  
pp. 000313482110385
Author(s):  
David P Stonko ◽  
Faris K. Azar ◽  
Richard D. Betzold ◽  
Jonathan J. Morrison ◽  
Ryan B. Fransman ◽  
...  
Keyword(s):  
Inferior Vena Cava ◽  
Vascular Injury ◽  
Inferior Vena ◽  
Management Strategies ◽  
Vena Cava ◽  
Multicenter Trial ◽  
Data Set ◽  
Injury Treatment ◽  
Contemporary Management ◽  
Injury Burden

Introduction Injuries to the inferior vena cava (IVC), while uncommon, have a high mortality despite modern advances. The goal of this study is to describe the diagnosis and management in the largest available prospective data set of vascular injuries across anatomic levels of IVC injury. Methods The American Association for the Surgery of Trauma PROspective Observational Vascular Injury Treatment (PROOVIT) registry was queried from November 2013 to January 2019. Demographics, diagnostic modalities, injury patterns, and management strategies were recorded and analyzed. Comparisons between anatomic levels were made using non-parametric Wilcoxon rank-sum statistics. Results 140 patients from 19 institutions were identified; median age was 30 years old (IQR 23-41), 75% were male, and 62% had penetrating mechanism. The suprarenal IVC group was associated with blunt mechanism (53% vs 32%, P = .02), had lower admission systolic blood pressure, pH, Glasgow Coma Scale (GCS), and higher ISS and thorax and abdomen AIS than the infrarenal injury group. Injuries were managed with open repair (70%) and ligation (30% overall; infrarenal 37% vs suprarenal 13%, P = .01). Endovascular therapy was used in 2% of cases. Overall mortality was 42% (infrarenal 33% vs suprarenal 66%, P<.001). Among survivors, there was no difference in first 24-hour PRBC transfusion requirement, or hospital or ICU length of stay. Conclusions Current PROOVIT registry data demonstrate continued use of ligation extending to the suprarenal IVC, limited adoption of endovascular management, and no dramatic increase in overall survival compared to previously published studies. Survival is likely related to IVC injury location and total injury burden.

scholarly journals Comprehensive managements of metastatic renal tumor with Mayo III inferior vena cava tumor thrombus: a case report

2020 ◽  
Vol 9 (2) ◽  
pp. 812-818
Author(s):  
Chenkui Miao ◽  
Yuhao Wang ◽  
Chao Hou ◽  
Wen Chen ◽  
Aiming Xu ◽  
...  
Keyword(s):  
Case Report ◽  
Inferior Vena Cava ◽  
Tumor Thrombus ◽  
Inferior Vena ◽  
Renal Tumor ◽  
Vena Cava

scholarly journals Recurrent Renal Tumor Thrombus in Inferior Vena Cava After Surgery: Surgical Management and Clinicopathological Features from a Large Chinese Center

2021 ◽  
Author(s):  
Zhuo Liu ◽  
Yuxuan Li ◽  
Guodong Zhu ◽  
Liyuan Ge ◽  
Shiying Tang ◽  
...  
Keyword(s):  
Inferior Vena Cava ◽  
Partial Nephrectomy ◽  
Radical Nephrectomy ◽  
Tumor Thrombus ◽  
Inferior Vena ◽  
Renal Tumor ◽  
Vena Cava ◽  
Clinicopathological Features ◽  
Recurrent Tumor

Abstract Background: To summarize the surgical technique and clinicopathological features of recurrent renal tumor thrombus in inferior vena cava (IVC) after surgery.Methods: We retrospectively analyzed the clinicopathological data of nine patients with recurrent renal tumor thrombus in IVC after surgery, who were admitted to Peking University Third Hospital between November 2015 and March 2021. Results: Among the nine patients, six patients (66.7%) developed recurrent tumor thrombus in the IVC after radical nephrectomy; two cases (22.2%) were recurrent tumor thrombus in the IVC after partial nephrectomy. One patient (11.1%) underwent partial nephrectomy first and radical nephrectomy for the second time. The recurrence of tumor thrombus in the IVC occurred after the operation. All the nine patients underwent open surgery for IVC thrombectomy. Eight patients (88.9 %) were operated smoothly. Among these eight patients, six patients (75%) underwent IVC segmental resection, and two patients (25%) underwent IVC thrombectomy. Another patient underwent IVC tumor thrombus exclusion. Median operative time was 380 (IQR: 338.5–540.5) min. Median estimated intraoperative blood loss was 1200 (IQR: 600–2250) ml. According to the modified Clavien classification system, one patient had grade I complications, three patients had grade II complications, and one patient had grade IVa complications. During a 20-months (range, 2-58 months) follow-up, tumor-specific death occurred in three patients and distant metastasis occurred in six patients.Conclusions: The operation of recurrent renal tumor thrombus in IVC after surgery is difficult. For patients with high-risk renal cell carcinoma, more close follow-up should be conducted after operation.

scholarly journals Resection of Large Urological Tumors With or Without Inferior Vena Cava Extension in Jehova's Witnesses

2020 ◽  
Vol 7 ◽  
Author(s):  
Gaetano Ciancio ◽  
Javier Gonzalez
Keyword(s):  
Blood Loss ◽  
Inferior Vena Cava ◽  
Surgical Approach ◽  
Tumor Thrombus ◽  
Inferior Vena ◽  
Perioperative Complications ◽  
Vena Cava ◽  
Renal Tumors ◽  
Adrenal Tumors ◽  
Estimated Blood Loss

Background: Renal and adrenal tumors with/without tumor thrombus in the inferior vena cava (IVC) pose a challenge to the surgeon due to the potential for massive hemorrhage and tumor thromboemboli. The situation would be more critical for Jehovah's Witness (JW) patients which refuse blood transfusion. A transplant-based (TB) approach to these tumors in JWs would result a safe surgical method, providing limited blood loss and perioperative complications. We report our experience using a TB surgical approach in JW harboring large adrenal/renal tumors with/without tumor thrombus trying to determine its usefulness in this setting.Patients and Methods: From 2003 to 2011, 7 patients underwent resection of renal/adrenal tumors with/without tumor thrombus in the IVC by means of a TB approach. Thrombus level was renal (n = 2), retrohepatic (n = 1), and suprahepatic (n = 1). The remaining 3 patients did not present thrombus. No pre-operative optimization or cell-saver were used. Estimated blood loss, perioperative complications (Clavien-Dindo and cause), hemoglobin/hematocrit loss, and length of stay were considered main outcomes.Results: The intervention was successfully completed without transfusion in all cases. Operative time and blood loss were 2.5 h (range: 1.83–5.75) and 150 cc (range: 100–750), respectively. No major post-operative complications were registered. However, minor complications were detected in 57% of the patients included. Median hemoglobin loss was 1.13 mg/dL, which translated a median hematocrit loss of 2.3%. Patients were discharged in a median of 7 days (range 5–20).Conclusions: A TB-surgical approach provides enhanced retroperitoneal exposure and optimal vascular control, thus limiting operative blood loss or major complication development, thus resulting useful in JWs.

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