Hand-assisted laparoscopic radical nephrectomy in the treatment of a renal cell carcinoma with a level ii vena cava thrombus

Kovac, Jason R.; Luke, Patrick

doi:10.1590/s1677-55382010000300009

Cited by 14 publications

(9 citation statements)

References 12 publications

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“…In 1996, McDougall et al presented the first successful LRN with level I thrombectomy (3). During the following years, many case series studies involving LRN with level I thrombectomy were reported proving that the procedure was feasible (4,5). In this procedure, the tumor thrombus was "milked back" into the renal vein so as to block the vein with vascular clips or an endoscopic stapling device (13).…”

Section: Discussionmentioning

confidence: 99%

“…Since the first description of laparoscopic radical nephrectomy (LRN) with level I vena cava thrombectomy in 1996 (3), several medical centers presented laparoscopic approach to deal with RCC with level I thrombus with encouraging outcomes (4,5). One case of renal tumor with IVTT extended 3cm above the renal vein (level II tumor thrombus) managed with pure LRN with tumor thrombectomy was reported in 2006 (6).…”

Section: Introductionmentioning

confidence: 99%

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Pure Conventional Laparoscopic Radical Nephrectomy with Level II Vena Cava Tumor Thrombectomy

et al. 2014

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ARTICLE INFO ______________________________________________________________ ______________________The surgical management with laparoscopic technique for renal cell carcinoma with inferior vena cava tumor thrombus (IVTT) remains challenging and technically demanding in urological oncology. We present two patients with level II IVTT that were managed with pure conventional laparoscopic radical nephrectomy and thrombectomy. Two patients were diagnosed with a renal tumor with level II IVTT from December 2011 to January 2012. They both underwent pure conventional laparoscopic radical nephrectomy with thrombectomy. During these operations, intraoperative laparoscopic ultrasonography was used to detect the thrombus and ensure complete removal. Two patients were operated through retroperitoneal approach for right renal tumor and transperitoneal approach for left renal tumor respectively. The demographics, perioperative and follow-up data were recorded for the study. Both operations were successfully performed without conversion. They both had no radiographic evidence of recurrence during follow-up. It is concluded that it is feasible to manage renal cell carcinoma with level II IVTT through pure conventional laparoscopic approach in carefully selected patients, which might expand the indication for laparoscopic surgery. The pure laparoscopic approach in the treatment of renal cell carcinoma with level II vena cava tumor thrombus is challenging and requires advanced laparoscopic skills. Multicenter prospective randomized control trials are needed to prove the benefits of this approach.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Pure Conventional Laparoscopic Radical Nephrectomy with Level II Vena Cava Tumor Thrombectomy

et al. 2014

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“…At present, open surgery is still the standard approach for RCC with IVCTT [4]. Recently, laparoscopy is increasingly being used in RCC patients with IVCTT due to the improvement of the minimally invasive techniques and the accumulation of surgical experiences, and it has been proved to be safe and effective in selected patients [5][6][7][8][9][10][11][12]. Whether open surgery or laparoscopic surgery, it is necessary to clamp the inferior vena cava (IVC) below the inferior margin of TT and above the superior margin of the TT, followed by removing of the TT.…”

Section: Introductionmentioning

confidence: 99%

Modified IVC Clamping Technique in the Left Radical Nephrectomy and Mayo II-III IVC Thrombectomy: A Preliminary Experience

Chen¹,

Yang²,

Ge³

et al. 2020

Preprint

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Background: To present our initial experiences on the left radical nephrectomy (RN) and Mayo II-III IVC thrombectomy (IVCTE) using modified inferior vena cava (IVC) clamping technique. Methods: From November 2016 to July 2018, eight left renal cell carcinoma (RCC) patients with inferior vena cava tumor thrombus (IVCTT) underwent retroperitoneal laparoscopic RN and IVCTE using the modified IVC clamping technique. During the IVCTE, the infrarenal IVC, right renal artery, right renal vein were clamped sequentially, then the cephalic IVC of the tumor thrombus was clamped immediately after the thrombus was removed.Results: According to the preoperative plans, all 8 operations were completed successfully without perioperative mortality. Median operative time was 438 min (343-573 min). Median IVC blocking time was 18 min (12-28min), and median warm ischemia time (WIT) for the right kidney was 19min (14-28min). Median estimated intraoperative blood loss was 1107mL (50-6000 ml). Some 50% of patients required an intraoperative blood transfusion. Median length of hospital stay was 12.9 days (6-39). Early postoperative complications occurred in 2 cases, 1 was Clavien class II, another was Clavien class IVa. All 8 patients were followed up continually with a median follow-up period of 16 months (5-25 months). During the mean follow-up period, three patients developed metastatic disease.Conclusions: Modified IVC clamping technique, which is feasible and safe for experienced surgeons in selected patients, can simplify the procedures left RN and Mayo II-III IVCTE.

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“…[1] Laparoscopy has gained only limited application for IVC tumor thrombi and only for short thrombi that could be milked out of the IVC or in conjunction with an open incision for the IVC manipulation and tumor extraction. [2345678]…”

Section: Introductionmentioning

confidence: 99%

Technical considerations in robotic nephrectomy with vena caval tumor thrombectomy

Abaza

2014

Indian J Urol

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Robotic surgery has been applied to increasingly complex urologic procedures since its initial widespread adoption for prostatectomy. While laparoscopic nephrectomy was initially reported over 2 decades ago, renal tumors involving the inferior vena cava (IVC) appeared to be a limitation to the application of laparoscopy. Laparoscopic management had only been reported in a limited fashion for short tumor thrombi not requiring cross-clamping of the IVC. The first robotic nephrectomy for renal cancer with IVC tumor thrombus was performed in 2008 with the first series reported in 2011, including for larger tumor thrombi requiring IVC cross-clamping for thrombus extraction. Since then, several surgeons at various institutions have adopted robotic surgery for these complex procedures. With experience and meticulous surgical technique, the procedure can be reproduced in properly selected cases. Further adoption and reports of multi-institutional experiences are necessary to validate this still relatively new procedure, and such work is already underway.

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Hand-assisted laparoscopic radical nephrectomy in the treatment of a renal cell carcinoma with a level ii vena cava thrombus

Cited by 14 publications

References 12 publications

Pure Conventional Laparoscopic Radical Nephrectomy with Level II Vena Cava Tumor Thrombectomy

Pure Conventional Laparoscopic Radical Nephrectomy with Level II Vena Cava Tumor Thrombectomy

Modified IVC Clamping Technique in the Left Radical Nephrectomy and Mayo II-III IVC Thrombectomy: A Preliminary Experience

Technical considerations in robotic nephrectomy with vena caval tumor thrombectomy

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