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

Frontiers in Surgery

Gaetano Ciancio¹  Ahmed Farag²  Tomas Salerno³ 

[1] Department of Surgery, Jackson Memorial Hospital, University of Miami Miller School of Medicine, Miami, FL, United States;Division of Transplantation, Jackson Memorial Hospital, University of Miami Miller School of Medicine, Miami, FL, United States;Division of Urology, Jackson Memorial Hospital, University of Miami Miller School of Medicine, Miami, FL, United States;Miami Transplant Institute, Jackson Memorial Hospital, University of Miami Miller School of Medicine, Miami, FL, United States;Department of Surgery, Jackson Memorial Hospital, University of Miami Miller School of Medicine, Miami, FL, United States;Division of Transplantation, Jackson Memorial Hospital, University of Miami Miller School of Medicine, Miami, FL, United States;Miami Transplant Institute, Jackson Memorial Hospital, University of Miami Miller School of Medicine, Miami, FL, United States;Department of Surgery, Zagazig University School of Medicine, Zagazig, Egypt;Division of Cardiothoracic Surgery, Jackson Memorial Hospital, University of Miami Miller School of Medicine, Miami, FL, United States;

关键词: renal cell carcinoma;    tumor thrombus;    right atrium;    cardiopulmonary bypass;    coronary artery bypass grafting;    thrombectomy;   

DOI  :  10.3389/fsurg.2021.676245

来源: Frontiers

【 摘 要 】

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.

【 授权许可】

CC BY