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Year : 2004  |  Volume : 20  |  Issue : 2  |  Page : 90-94

Renal cell carcinoma with tumor thrombus extension to inferior vena cava: SGPGIMS experience

Department of Urology & Renal Transplantation, Sanjay Gandhi Post-Graduate Institute of Medical Sciences, Lucknow, India

Correspondence Address:
Aneesh Srivastava
Department of Urology & Renal Transplantation, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow - 226 014
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Source of Support: None, Conflict of Interest: None

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Objectives : Renal cell carcinoma with tumor thrombus extension to inferior vena cava is found in 4-10% of pa­tients. We evaluated the surgical techniques of thrombec­tomy for different levels of the tumor thrombus in inferior vena cava and overall surgical outcome in these patients. Methods : We retrospectively reviewed the records of 17 patients operated between 1994 and 2001. Eleven pa­tients had Infrahepatic (level I) thrombus, retrohepatic (level II) thrombus in two patients and four had supra­diaphragmatic (level III) thrombus without intra-a trial extension. All patients underwent radical nephrectomy and vena caval thrombectomy. The retrohepatic and supradia­phragmatic thrombectomies were done under venovenous bypass. Results : The patients with infrahepatic and retrohepatic thrombectomies recovered without any major post opera­tive complication. Two patients with supradiaphragmatic thrombectomy died in postoperative period. The overall 2-year and 5-year survivals were 64.9% and 29.5% respectively. Conclusions: Radical nephrectomy and vena caval thrombectomy is the best treatment option in renal call carcinoma with tumor thrombus extending to inferior vena cava. The retrohepatic and supradiaphragmatic thrombec­tomies can be done with the help of venovenous bypass in select group of patients.

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