A novel technique for avoidance of sternotomy, diaphragmic incision and cardiopulmonary bypass during cavoatrial tumor thrombectomy for renal cell carcinoma with intraatrial tumor thrombus: a case series at a single center

BMC Surgery

Research

Fajuan Cheng¹  Yaqing Liu¹  Yiming Zhang²  Zhongshun Yao²  Wei He²  Zhihong Niu³  Zixiang Cong⁴ 

[1] Department of Nephrology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China;Department of Urology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, 324, Jingwu Road, Huaiying District, 250021, Jinan, Shandong, China;Department of Urology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, 324, Jingwu Road, Huaiying District, 250021, Jinan, Shandong, China;Department of Urology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong province, China;Department of Urology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong province, China;

关键词: Renal cell carcinoma;    Surgery;    Atrium;    Tumor Thrombus;    Cardiopulmonary bypass;   

DOI  :  10.1186/s12893-023-02156-7

 received in 2023-05-01, accepted in 2023-08-16,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundRadical nephrectomy with thrombectomy in patients with renal cell carcinoma (RCC) and level IV thrombus extending to the right atrium (RA) offers improved survival. However, this procedure is associated with significant perioperative morbidity and mortality. In this report, we describe a novel milking technique for patients with RA tumor thrombus using abdominal access, which does not require diaphragmic incision, sternotomy, right atriotomy, or cardiopulmonary bypass (CPB).MethodsBetween January 2019 and January 2022, four patients underwent resection of renal cell carcinoma extending into RA by a milking technique developed to avoid diaphragmic incision, sternotomy, or CPB. Patient characteristics, perioperative data, pathological features, and survival were evaluated.ResultsComplete resection was successful through pure transabdominal access without diaphragmic incision, sternotomy, or CPB in all patients.ConclusionWe conclude that radical nephrectomy and thrombectomy in optimized cases with renal cell carcinoma extending into RA can be safely and effectively performed without diaphragmic incision, sternotomy, or CPB, avoiding serious perioperative complications while providing acceptable oncological outcomes.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023