Key result
Upfront saphenous vein grafting during IVC leiomyosarcoma resection preserves left renal function and disease-free survival.
Why the study?
Leiomyosarcoma of the inferior vena cava involving bilateral renal veins presents a major surgical challenge.
Does upfront saphenous vein interposition graft for left renal vein outflow followed by radical resection and IVC reconstruction improve outcomes in patients with leiomyosarcoma of the IVC involving bilateral renal veins?
Case Report (n=2)
No
Does upfront saphenous vein interposition graft for left renal vein outflow followed by radical resection and IVC reconstruction improve outcomes in patients with leiomyosarcoma of the IVC involving bilateral renal veins?
Upfront saphenous vein interposition grafting for left renal vein outflow is a viable surgical strategy to ensure radical resection and preserve renal function in complex IVC leiomyosarcomas involving bilateral renal veins.
Supports individualized reconstruction in rare bilateral IVC tumors; leaves open durability and generalizability.
Leiomyosarcoma of inferior vena cava (IVC) involving bilateral renal veins presents a surgical challenge. Herein, we report the successful management of two such cases using restoration of left renal venous outflow by saphenous vein interposition graft as first step of surgery. Then radical resection of tumor and right kidney was done. IVC was lastly reconstructed using Gore-Tex graft. This report highlights the surgical challenges to ensure radical resection. Furthermore, the importance of restoring left renal outflow in presence of concomitant right nephrectomy is discussed. Both the patients were disease free at six months with no loss of left renal glomerular filtration rate.
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Seth et al. (2010) conducted a case report in Leiomyosarcoma of inferior vena cava involving bilateral renal veins (n=2). Restoration of left renal venous outflow by saphenous vein interposition graft followed by radical resection and IVC reconstruction was evaluated on Disease-free survival and preservation of left renal glomerular filtration rate. Upfront restoration of left renal venous outflow using a saphenous vein interposition graft during radical resection of IVC leiomyosarcoma resulted in disease-free survival at 6-9 months with preserved left renal function.
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