Inferior venacavography for renal cell carcinoma combined with inferior vena cava thrombus
Shen Dan
Chang Xiao
Du Songliang
Liu Fengyong
Li Hongzhao
Wang Baojun
Shi Taoping
Zhu Jie
Huang Qingbo
Wang Zhongxin
Jia Zhuomin
Zhang Peng
Lyu Xiangjun
Fan Yang
Gao Yu
Peng Cheng
Li Shichao
Liu Kan
Zhang Xu
Ma Xin
Abstract：Objective:Inferior venacavography has special advantages in the preoperative assessment for renal cell carcinoma(RCC)combined with inferior vena cava(IVC)tumor thrombus,but it hasn't been widely used for its doubtful safety and efficacy.The purpose of this study is to evaluate the utility of inferior venacavography in RCC with IVC tumor thrombus and to definite its indications.Methods:We reviewed clinical data of 9 patients diag-nosed as RCC combined with IVC thrombus undergoing preoperative inferior venacavography from January 2017 to June 2017.Radiographic data were retrospectively analyZed to identify the obstruction location of IVC,extension of tumor thrombus,and the establishment of distal collateral circulation.Results:Nine patients were included in the analysis, including 5 females(55.6%)and 4 males(44.4%).To conduct inferior venacavography,all patients accepted right femoral vein puncture under local anaesthesia and then the catheter was inserted over the guidewire to inject contrast medium.None of them showed any complication after venacavography until surgery was conducted.As for surgery,7 cases underwent robotic assisted laparoscopic radical nephrectomy and IVC thrombectomy,and 2 cases were given open radical nephrectomy and IVC transection.Four cases were classified as Mayo Ⅲ,4 cases as Mayo Ⅱ and 1 as Mayo Ⅰ.The mean length of the IVC thrombus was 7.9 cm(SD:2.4).Mean operation time was 335.6 min(SD:94.1).Mean blood loss was 2 200mL(SD:2 089mL).Mean postoperative hospital stay was 18.8 days(SD:5.9).Postoperative complications included thrombosis in the common iliac vein and internal iliac vein(1 case),and retroperitoneal hematoma and anemia(1 case).During the follow-up period of 2-5 months,ve-nacavography showed patent IVC or adequate collateral circulation establishment in all patients,and no lower ex-tremity edema or abdominal varicose veins was observed.Conclusions:Inferior venacavography is a safe and effec-tive preoperative assessment for RCC combined with tumor thrombus in IVC.Further large sample studies are needed to evaluate the application of venacavography.
Keywords：renal tumourinferior vena cavathrombusvenacavography
Publication Date：2018-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 83-87 )