Key result
Off-pump IVC tumor thrombectomy enables successful resection in patients with prior CABG.
Why the study?
Surgical management of RCC with IVC tumor thrombus extending to hepatic veins and RA is challenging, especially in patients with previous CABG requiring re-sternotomy and CPB.
Case Report (n=2)
No
Surgical resection of renal cell carcinoma with inferior vena cava tumor thrombus can be successfully performed without cardiopulmonary bypass in patients with previous CABG.
Supports technical feasibility of re-sternotomy and CPB for RCC with IVC/RA thrombus after prior CABG; leaves open need for larger outcome studies.
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.
No takes yet. Share an insight, caveat, or question.
Ciancio et al. (2021) conducted a case report in Renal cell carcinoma with inferior vena cava tumor thrombus and previous CABG (n=2). Trans-abdominal surgical resection and tumor thrombectomy without cardiopulmonary bypass was evaluated on Successful surgical resection without cardiopulmonary bypass. Trans-abdominal surgical resection and tumor thrombectomy without cardiopulmonary bypass was successfully performed in two patients with renal cell carcinoma, IVC tumor thrombus, and previous CABG.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: