Simultaneous management of renal carcinoma with caval vein thrombosis and double coronary artery disease

Grasso, Marco; Blanco, Salvatore; Formica, Francesco; Paolini, Giovanni; Grasso, Angelica

doi:10.4081/aiua.2013.4.207

Cited by 2 publications

(2 citation statements)

References 12 publications

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“…There have been reports of two other patients having RCC and the presence of CAD ( 12 , 13 ), including one RCC case with TT extending into the RA in a patient with previous sternotomy ( 13 ), with good outcomes observed in both patients. Our patients were different in that we were able to remove the TT below and above diaphragm without CPB as previously described ( 9 , 10 ), and our surgeries were also successful.…”

Section: Discussionmentioning

confidence: 99%

Renal Cell Carcinoma With Inferior Vena Cava Tumor Thrombus in Two Patients With Previous Coronary Artery Bypass Graft: Strategy for Surgical Removal

2021

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Surgical management of renal cell carcinoma (RCC) with tumor thrombus (TT) extending into the inferior vena cava (IVC) and up to the hepatic veins and right atrium (RA) continues to be problematic and a challenging surgical operation. It becomes even more complicated when performing a re-sternotomy and cardiopulmonary bypass (CPB) in patients with previous coronary artery bypass grafting (CABG). Here, we report on two patients with previous CABG who presented with RCC and TT extending into the hepatic vein and above the diaphragm. These two patients underwent successful surgical resection and TT thrombectomy without the need of CBP. Recommendations are made for successfully accomplishing such surgical resections, including adequate prior preparation for the possible need to perform re-sternotomy and CPB with a coordinated team effort.

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Section: Discussionmentioning

confidence: 99%

Renal Cell Carcinoma With Inferior Vena Cava Tumor Thrombus in Two Patients With Previous Coronary Artery Bypass Graft: Strategy for Surgical Removal

2021

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“…Cancer patients at high risks of perioperative cardiac complications and mortality are recommended to undergo CS before definitive oncological therapy [ 14 – 18 ]. Published reports of surgery in patients with kidney malignancies and concomitant cardiac disease include experiences with 6 to 9 cases [ 12 , 6 ] and isolated cases of cardiac interventions in patients with renal cell carcinoma and caval tumor thrombus [ 19 , 20 ]. To our knowledge, we present the largest series of cases of simultaneous (15 cases) and staged (14 cases) surgery for renal tumors and concomitant cardiac disease.…”

Section: Discussionmentioning

confidence: 99%

Simultaneous or staged surgery in patients with kidney tumors and concomitant cardiac disease

Andrushchuk

Ostrovsky

Krasny

et al. 2017

CEJU

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IntroductionTo evaluate outcomes of simultaneous and staged surgery in patients with kidney tumors and concomitant cardiac disease.Material and methodsBetween October 2001 and October 2015, fifteen patients (Group 1) underwent simultaneous surgery and fourteen patients (Group 2) underwent staged surgery. 89.7% were males (26/29), and the mean age was 60.8 ±1.16 years. Locally advanced cancers (Stage III) were registered in the two groups in 11 vs. 3 patients (p = 0.016) and localized (Stage I) disease in 2 vs. 10 (p = 0.007), respectively. 18 patients (62%) were operated for coronary heart disease, while 10 patients (35%) underwent surgery for valvular heart disease. Nephrectomy was performed in 14rs 5 patients respectively (p = 0.003) while partial nephrectomy in 1rs 7 patients (p = 0.005).ResultsIn the two groups, the 30-day mortality was 13% (2 cases) and 7% (1 case), p = 1.0, and major hospital complications were observed in 3 (20%) and 2 (14%) cases, respectively, p = 0.53. The median follow-up in Group 1 and Group 2 was 87 months (range, 23.3 to 146.8 months) and 39 months (range, 3.9 to 98 months), respectively, p = 0.001. Three-year overall survival was 73.3 ±11.4% (95% CI 50.5–96.1) and 77.9 ±11.3%, respectively, p = 0.70, and three-year disease-free survival was 83.9 ±10.4% and 75.0 ±21.7%, respectively, p = 0.91.ConclusionsSimultaneous and staged surgery for kidney tumors and concomitant cardiac disease are feasible procedures. Patients with advanced tumors and complicated disease course can benefit from early intervention and consequently a simultaneous approach can be a preferred option for them. For localized renal tumors, staged surgery should be used.

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Simultaneous management of renal carcinoma with caval vein thrombosis and double coronary artery disease

Abstract: The postoperative course was uneventful. Simultaneous surgery proved to be beneficial and safe, showing optimal results in our patient.

Cited by 2 publications

References 12 publications

Renal Cell Carcinoma With Inferior Vena Cava Tumor Thrombus in Two Patients With Previous Coronary Artery Bypass Graft: Strategy for Surgical Removal

Renal Cell Carcinoma With Inferior Vena Cava Tumor Thrombus in Two Patients With Previous Coronary Artery Bypass Graft: Strategy for Surgical Removal

Simultaneous or staged surgery in patients with kidney tumors and concomitant cardiac disease

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