Surgical treatment of patients with renal cell cancer complicated by specific (tumor) and non-specific thrombosis of the inferior Vena cava
Among malignant neoplasms, kidney cancer occupies one of the first places in terms of the growth rate of incidence in Russia. Despite the possibilities of modern diagnostic research methods, the number of patients with common forms of the disease does not decrease. In 5–10% of cases, renal cell carc...
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QUASAR, LLC
2020-09-01
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| Series: | Исследования и практика в медицине |
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| Online Access: | https://www.rpmj.ru/rpmj/article/view/592 |
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| author | N. V. Vorobev F. S. Ashyrova M. P. Golovashchenko L. O. Petrov A. D. Kaprin |
| author_facet | N. V. Vorobev F. S. Ashyrova M. P. Golovashchenko L. O. Petrov A. D. Kaprin |
| author_sort | N. V. Vorobev |
| collection | DOAJ |
| description | Among malignant neoplasms, kidney cancer occupies one of the first places in terms of the growth rate of incidence in Russia. Despite the possibilities of modern diagnostic research methods, the number of patients with common forms of the disease does not decrease. In 5–10% of cases, renal cell carcinoma is complicated by the formation of a tumor clot in the inferior Vena cava (VCI), which requires volume surgery — nephrectomy with thrombectomy, which is the only effective treatment option for this group of patients. Previously, the results of treatment of locally advanced kidney cancer were unsatisfactory due to the high incidence of complications and mortality after extended surgical interventions. However, improving the operation technique requires a re-evaluation of previous representations. Performing a nephrectomy with a VCI thrombectomy is not an easy task and is often associated not only with technical difficulties due to the need for mobilization, control and resection of the inferior Vena cava, but also with the risk of intra — and postoperative complications. The most difficult task is the choice of surgical tactics for descending non-tumor hemorrhagic thrombosis. As a result of long-term tumor obstruction, organized blood clots that are soldered to the intima of the vessel often spread to the common iliac veins and, as a rule, are technically impossible to remove. If the VCI is preserved, a residual hemorrhagic blood clot in the area of its confluence is a potential source of pulmonary embolism (PE), for the prevention of which mechanical plication is used. This maneuver does not lead to the development of clinically significant chronic venous insufficiency of the lower extremities (CVI NC), postoperative VCI or PE thrombosis. Despite the technical complexity of the operation and the difficult course of the postoperative period, surgical treatment of renal cell cancer complicated by tumor thrombosis is certainly justified. This article presents a clinical case of surgical treatment of a patient with renal cell cancer complicated by massive specific (tumor) and non-specific thrombosis in the presence of reduced parenchymalexcretory function of the contralateral kidney and severe cardiac pathology. Goal: to share experience and demonstrate the results of successful surgical treatment of renal cell carcinoma. |
| format | Article |
| id | doaj-art-67d1240fd8304c2cb2019d7afedee5fa |
| institution | Kabale University |
| issn | 2410-1893 |
| language | Russian |
| publishDate | 2020-09-01 |
| publisher | QUASAR, LLC |
| record_format | Article |
| series | Исследования и практика в медицине |
| spelling | doaj-art-67d1240fd8304c2cb2019d7afedee5fa2025-02-03T00:57:37ZrusQUASAR, LLCИсследования и практика в медицине2410-18932020-09-0173919810.17709/2409-2231-2020-7-3-9341Surgical treatment of patients with renal cell cancer complicated by specific (tumor) and non-specific thrombosis of the inferior Vena cavaN. V. Vorobev0F. S. Ashyrova1M. P. Golovashchenko2L. O. Petrov3A. D. Kaprin4P.A.Hertsen Moscow Oncology Research Institute – Branch of the National Medical Research Radiological Centre; I.M.Sechenov First Moscow State Medical UniversityP.A.Hertsen Moscow Oncology Research Institute – Branch of the National Medical Research Radiological CentreP.A.Hertsen Moscow Oncology Research Institute – Branch of the National Medical Research Radiological CentreP.A.Hertsen Moscow Oncology Research Institute – Branch of the National Medical Research Radiological Centre; A.F.Tsyb Medical Radiological Research Center – Branch of the National Medical Research Radiological CenterP.A.Hertsen Moscow Oncology Research Institute – Branch of the National Medical Research Radiological Centre; Peoples Friendship University of RussiaAmong malignant neoplasms, kidney cancer occupies one of the first places in terms of the growth rate of incidence in Russia. Despite the possibilities of modern diagnostic research methods, the number of patients with common forms of the disease does not decrease. In 5–10% of cases, renal cell carcinoma is complicated by the formation of a tumor clot in the inferior Vena cava (VCI), which requires volume surgery — nephrectomy with thrombectomy, which is the only effective treatment option for this group of patients. Previously, the results of treatment of locally advanced kidney cancer were unsatisfactory due to the high incidence of complications and mortality after extended surgical interventions. However, improving the operation technique requires a re-evaluation of previous representations. Performing a nephrectomy with a VCI thrombectomy is not an easy task and is often associated not only with technical difficulties due to the need for mobilization, control and resection of the inferior Vena cava, but also with the risk of intra — and postoperative complications. The most difficult task is the choice of surgical tactics for descending non-tumor hemorrhagic thrombosis. As a result of long-term tumor obstruction, organized blood clots that are soldered to the intima of the vessel often spread to the common iliac veins and, as a rule, are technically impossible to remove. If the VCI is preserved, a residual hemorrhagic blood clot in the area of its confluence is a potential source of pulmonary embolism (PE), for the prevention of which mechanical plication is used. This maneuver does not lead to the development of clinically significant chronic venous insufficiency of the lower extremities (CVI NC), postoperative VCI or PE thrombosis. Despite the technical complexity of the operation and the difficult course of the postoperative period, surgical treatment of renal cell cancer complicated by tumor thrombosis is certainly justified. This article presents a clinical case of surgical treatment of a patient with renal cell cancer complicated by massive specific (tumor) and non-specific thrombosis in the presence of reduced parenchymalexcretory function of the contralateral kidney and severe cardiac pathology. Goal: to share experience and demonstrate the results of successful surgical treatment of renal cell carcinoma.https://www.rpmj.ru/rpmj/article/view/592kidney cell cancerradical nephrectomythrombectomyinferior vena cavailiac veinthrombosisclinical case |
| spellingShingle | N. V. Vorobev F. S. Ashyrova M. P. Golovashchenko L. O. Petrov A. D. Kaprin Surgical treatment of patients with renal cell cancer complicated by specific (tumor) and non-specific thrombosis of the inferior Vena cava Исследования и практика в медицине kidney cell cancer radical nephrectomy thrombectomy inferior vena cava iliac vein thrombosis clinical case |
| title | Surgical treatment of patients with renal cell cancer complicated by specific (tumor) and non-specific thrombosis of the inferior Vena cava |
| title_full | Surgical treatment of patients with renal cell cancer complicated by specific (tumor) and non-specific thrombosis of the inferior Vena cava |
| title_fullStr | Surgical treatment of patients with renal cell cancer complicated by specific (tumor) and non-specific thrombosis of the inferior Vena cava |
| title_full_unstemmed | Surgical treatment of patients with renal cell cancer complicated by specific (tumor) and non-specific thrombosis of the inferior Vena cava |
| title_short | Surgical treatment of patients with renal cell cancer complicated by specific (tumor) and non-specific thrombosis of the inferior Vena cava |
| title_sort | surgical treatment of patients with renal cell cancer complicated by specific tumor and non specific thrombosis of the inferior vena cava |
| topic | kidney cell cancer radical nephrectomy thrombectomy inferior vena cava iliac vein thrombosis clinical case |
| url | https://www.rpmj.ru/rpmj/article/view/592 |
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