Surgical treatment of renal tumor with tumor thrombus in the inferior vena cava
Background/Aim. An aggressive approach with radical nephrectomy and thrombectomy is the mainstay of the treatment in patients with renal tumors. The aim of this study was to present the results of such surgical procedures performed in the last 25 years at our institution. Methods. We made a retrospe...
| Main Authors: | , , , , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Military Health Department, Ministry of Defance, Serbia
2023-01-01
|
| Series: | Vojnosanitetski Pregled |
| Subjects: | |
| Online Access: | https://doiserbia.nb.rs/img/doi/0042-8450/2023/0042-84502200058T.pdf |
| _version_ | 1797807526266273792 |
|---|---|
| author | Tomić Aleksandar Aleksić Predrag Milović Novak Ilić Radoje Marjanović Ivan Bančević Vladimir Leković Ivan Nešković Vojislava Mandarić Vladimir Kostić Zoran Šarac Momir Vukićević Petar Milev Boško Paunović Dragana Zarić Aleksandar Jovanović Dragana Sekulić Dragan Babić Luka Zoranović Radivoj |
| author_facet | Tomić Aleksandar Aleksić Predrag Milović Novak Ilić Radoje Marjanović Ivan Bančević Vladimir Leković Ivan Nešković Vojislava Mandarić Vladimir Kostić Zoran Šarac Momir Vukićević Petar Milev Boško Paunović Dragana Zarić Aleksandar Jovanović Dragana Sekulić Dragan Babić Luka Zoranović Radivoj |
| author_sort | Tomić Aleksandar |
| collection | DOAJ |
| description | Background/Aim. An aggressive approach with radical nephrectomy and thrombectomy is the mainstay of the treatment in patients with renal tumors. The aim of this study was to present the results of such surgical procedures performed in the last 25 years at our institution. Methods. We made a retrospective analysis of radical nephrectomy and thrombectomy in patients with renal tumor and tumor thrombus (TT) extending into the inferior vena cava (IVC) operated on at our institution between January 1995 and October 2021. Results. There were 92 patients (72 males and 20 females) aged 60.5 on average who were operated on in the mentioned period. A predominance of right-sided tumors was present in 73.33% of patients. Patients with TT in the renal vein (levels 0 and I) were not included. TT levels II, III, and IV were present in 32 (34.8%), 52 (56.5%), and 8 (8.7%) patients, respectively. One patient had thrombosis of the right pulmonary artery. Four patients had liver metastases, and ten had lymph node involvement. The surgical approach by subcostal incision was achieved in 8 (8.69%) patients, by chevron incision in only 11 (11.95%) patients, while in 73 (79.34%) patients, we performed median sternotomy and subcostal/chevron incision. Intraoperatively, there was one complication which was pulmonary thromboembolism. Six patient required re-exploration after the surgery due to the IVC hemorrhage. The three-year survival in patients with renal tumors and TT levels II−IV in the IVC was 43%. Conclusion. Surgery will remain the primary cure method in patients with renal tumors and TT in the IVC. Long-term survival in these patients can be achieved by complete surgical removal (radical nephrectomy and thrombectomy). |
| first_indexed | 2024-03-13T06:23:52Z |
| format | Article |
| id | doaj.art-85b1c76d3eea4ca5a234dd063c6df821 |
| institution | Directory Open Access Journal |
| issn | 0042-8450 2406-0720 |
| language | English |
| last_indexed | 2024-03-13T06:23:52Z |
| publishDate | 2023-01-01 |
| publisher | Military Health Department, Ministry of Defance, Serbia |
| record_format | Article |
| series | Vojnosanitetski Pregled |
| spelling | doaj.art-85b1c76d3eea4ca5a234dd063c6df8212023-06-09T10:44:56ZengMilitary Health Department, Ministry of Defance, SerbiaVojnosanitetski Pregled0042-84502406-07202023-01-0180430230910.2298/VSP220130058T0042-84502200058TSurgical treatment of renal tumor with tumor thrombus in the inferior vena cavaTomić Aleksandar0Aleksić Predrag1Milović Novak2Ilić Radoje3Marjanović Ivan4Bančević Vladimir5Leković Ivan6Nešković Vojislava7https://orcid.org/0000-0003-3583-7129Mandarić Vladimir8Kostić Zoran9Šarac Momir10Vukićević Petar11Milev Boško12Paunović Dragana13Zarić Aleksandar14Jovanović Dragana15Sekulić Dragan16https://orcid.org/0000-0002-3128-4953Babić Luka17https://orcid.org/0000-0001-5560-2824Zoranović Radivoj18Military Medical Academy, Clinic for Vascular and Endovascular Surgery, Belgrade, Serbia + University of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, SerbiaUniversity of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, Serbia + Military Medical Academy, Clinic for Urology, Belgrade, SerbiaUniversity of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, Serbia + Military Medical Academy, Clinic for Urology, Belgrade, SerbiaUniversity of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, Serbia + Military Medical Academy, Clinic for Cardiosurgery, Belgrade, SerbiaMilitary Medical Academy, Clinic for Vascular and Endovascular Surgery, Belgrade, Serbia + University of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, SerbiaUniversity of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, Serbia + Military Medical Academy, Clinic for Urology, Belgrade, SerbiaMilitary Medical Academy, Clinic for Vascular and Endovascular Surgery, Belgrade, Serbia + University of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, SerbiaUniversity of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, Serbia + Military Medical Academy, Clinic for Anesthesiology and Intensive Care, Belgrade, SerbiaMilitary Medical Academy, Clinic for Cardiosurgery, Belgrade, SerbiaUniversity of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, Serbia + Military Medical Academy, Clinic for General Surgery, Belgrade, SerbiaMilitary Medical Academy, Clinic for Vascular and Endovascular Surgery, Belgrade, Serbia + University of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, SerbiaUniversity of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, Serbia + Military Medical Academy, Clinic for Cardiosurgery, Belgrade, SerbiaUniversity of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, Serbia + Military Medical Academy, Clinic for General Surgery, Belgrade, SerbiaMilitary Medical Academy, Clinic for Vascular and Endovascular Surgery, Belgrade, SerbiaMilitary Medical Academy, Clinic for Vascular and Endovascular Surgery, Belgrade, SerbiaMilitary Medical Academy, Clinic for Anesthesiology and Intensive Care, Belgrade, SerbiaMilitary Medical Academy, Clinic for Vascular and Endovascular Surgery, Belgrade, SerbiaMilitary Medical Academy, Clinic for Cardiosurgery, Belgrade, SerbiaMilitary Medical Academy, Clinic for Vascular and Endovascular Surgery, Belgrade, SerbiaBackground/Aim. An aggressive approach with radical nephrectomy and thrombectomy is the mainstay of the treatment in patients with renal tumors. The aim of this study was to present the results of such surgical procedures performed in the last 25 years at our institution. Methods. We made a retrospective analysis of radical nephrectomy and thrombectomy in patients with renal tumor and tumor thrombus (TT) extending into the inferior vena cava (IVC) operated on at our institution between January 1995 and October 2021. Results. There were 92 patients (72 males and 20 females) aged 60.5 on average who were operated on in the mentioned period. A predominance of right-sided tumors was present in 73.33% of patients. Patients with TT in the renal vein (levels 0 and I) were not included. TT levels II, III, and IV were present in 32 (34.8%), 52 (56.5%), and 8 (8.7%) patients, respectively. One patient had thrombosis of the right pulmonary artery. Four patients had liver metastases, and ten had lymph node involvement. The surgical approach by subcostal incision was achieved in 8 (8.69%) patients, by chevron incision in only 11 (11.95%) patients, while in 73 (79.34%) patients, we performed median sternotomy and subcostal/chevron incision. Intraoperatively, there was one complication which was pulmonary thromboembolism. Six patient required re-exploration after the surgery due to the IVC hemorrhage. The three-year survival in patients with renal tumors and TT levels II−IV in the IVC was 43%. Conclusion. Surgery will remain the primary cure method in patients with renal tumors and TT in the IVC. Long-term survival in these patients can be achieved by complete surgical removal (radical nephrectomy and thrombectomy).https://doiserbia.nb.rs/img/doi/0042-8450/2023/0042-84502200058T.pdfkidney neoplasmsneoplasm metastasisvena cava, inferiorsurgical procedures, operativesurvival |
| spellingShingle | Tomić Aleksandar Aleksić Predrag Milović Novak Ilić Radoje Marjanović Ivan Bančević Vladimir Leković Ivan Nešković Vojislava Mandarić Vladimir Kostić Zoran Šarac Momir Vukićević Petar Milev Boško Paunović Dragana Zarić Aleksandar Jovanović Dragana Sekulić Dragan Babić Luka Zoranović Radivoj Surgical treatment of renal tumor with tumor thrombus in the inferior vena cava Vojnosanitetski Pregled kidney neoplasms neoplasm metastasis vena cava, inferior surgical procedures, operative survival |
| title | Surgical treatment of renal tumor with tumor thrombus in the inferior vena cava |
| title_full | Surgical treatment of renal tumor with tumor thrombus in the inferior vena cava |
| title_fullStr | Surgical treatment of renal tumor with tumor thrombus in the inferior vena cava |
| title_full_unstemmed | Surgical treatment of renal tumor with tumor thrombus in the inferior vena cava |
| title_short | Surgical treatment of renal tumor with tumor thrombus in the inferior vena cava |
| title_sort | surgical treatment of renal tumor with tumor thrombus in the inferior vena cava |
| topic | kidney neoplasms neoplasm metastasis vena cava, inferior surgical procedures, operative survival |
| url | https://doiserbia.nb.rs/img/doi/0042-8450/2023/0042-84502200058T.pdf |
| work_keys_str_mv | AT tomicaleksandar surgicaltreatmentofrenaltumorwithtumorthrombusintheinferiorvenacava AT aleksicpredrag surgicaltreatmentofrenaltumorwithtumorthrombusintheinferiorvenacava AT milovicnovak surgicaltreatmentofrenaltumorwithtumorthrombusintheinferiorvenacava AT ilicradoje surgicaltreatmentofrenaltumorwithtumorthrombusintheinferiorvenacava AT marjanovicivan surgicaltreatmentofrenaltumorwithtumorthrombusintheinferiorvenacava AT bancevicvladimir surgicaltreatmentofrenaltumorwithtumorthrombusintheinferiorvenacava AT lekovicivan surgicaltreatmentofrenaltumorwithtumorthrombusintheinferiorvenacava AT neskovicvojislava surgicaltreatmentofrenaltumorwithtumorthrombusintheinferiorvenacava AT mandaricvladimir surgicaltreatmentofrenaltumorwithtumorthrombusintheinferiorvenacava AT kosticzoran surgicaltreatmentofrenaltumorwithtumorthrombusintheinferiorvenacava AT saracmomir surgicaltreatmentofrenaltumorwithtumorthrombusintheinferiorvenacava AT vukicevicpetar surgicaltreatmentofrenaltumorwithtumorthrombusintheinferiorvenacava AT milevbosko surgicaltreatmentofrenaltumorwithtumorthrombusintheinferiorvenacava AT paunovicdragana surgicaltreatmentofrenaltumorwithtumorthrombusintheinferiorvenacava AT zaricaleksandar surgicaltreatmentofrenaltumorwithtumorthrombusintheinferiorvenacava AT jovanovicdragana surgicaltreatmentofrenaltumorwithtumorthrombusintheinferiorvenacava AT sekulicdragan surgicaltreatmentofrenaltumorwithtumorthrombusintheinferiorvenacava AT babicluka surgicaltreatmentofrenaltumorwithtumorthrombusintheinferiorvenacava AT zoranovicradivoj surgicaltreatmentofrenaltumorwithtumorthrombusintheinferiorvenacava |