PD56-08 EN BLOC RESECTION OF RIGHT RENAL CELL CARCINOMA AND INFERIOR VENA CAVA WITH TUMOR THROMBUS: IS IT SAFE TO DIVIDE THE LEFT RENAL VEIN?

Abstract

You have accessJournal of UrologyCME1 May 2022PD56-08 EN BLOC RESECTION OF RIGHT RENAL CELL CARCINOMA AND INFERIOR VENA CAVA WITH TUMOR THROMBUS: IS IT SAFE TO DIVIDE THE LEFT RENAL VEIN? Laura Horodyski, Javier Gonzalez, Marina Tabbara, Jeffrey Gaynor, Maria Rodriguez-Cabero, Felipe Herranz-Amo, Carlos Hernández, Rushi Shah, and Gaetano Ciancio Laura HorodyskiLaura Horodyski More articles by this author , Javier GonzalezJavier Gonzalez More articles by this author , Marina TabbaraMarina Tabbara More articles by this author , Jeffrey GaynorJeffrey Gaynor More articles by this author , Maria Rodriguez-CaberoMaria Rodriguez-Cabero More articles by this author , Felipe Herranz-AmoFelipe Herranz-Amo More articles by this author , Carlos HernándezCarlos Hernández More articles by this author , Rushi ShahRushi Shah More articles by this author , and Gaetano CiancioGaetano Ciancio More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002636.08AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: When renal cell carcinoma extends into the inferior vena cava, obstruction leads to redistribution of venous flow through collaterals. A few case reports have found that resection of the obstructed inferior vena cava without reconstruction may be safe in the short term with regard to renal function, though a transient increase in creatinine can be seen. The objective was to assess whether resection of a right renal cell carcinoma and inferior vena cava with obstructing tumor thrombus is safe to perform without reconstructing the inferior vena cava with regard to long-term renal function. METHODS: A bi-institutional retrospective review was performed over an 18 year period, assessing patients with right renal cell carcinoma and obstructing level II-IV tumor thrombus. RESULTS: Twenty-two patients were included in the study. Average age was 62.5 (range 45-79) years old and 19 (86%) of the patients were male. One patient (5%) had a level II thrombus, 14 patients (64%) had a level III thrombus (IIIa n=3, IIIb n=6, IIIc n= 3, IIId n=2), and seven patients (32%) had a level IV thrombus. Intra-operatively, average estimated blood loss was 1.35 (range 0.2 – 25) L. The average length of hospital stay was 11 (range 5 – 50) days. Average preoperative creatinine was 1.20 (range 0.40 – 2.70) mg/dL and postoperatively, average creatinine was 1.3 (range 0.86 – 2.20) mg/dL. Mean creatinine at 6 month and 12 month follow-up was 1.10 (range 0.5 – 1.6) and mg/dL 1.34 (range 0.6 – 2.0), respectively. Eight patients were lost to follow-up, and two died (one in the hospital, and the other three months post-operatively). CONCLUSIONS: Resection of right renal cell carcinoma with inferior vena cava in the presence of an obstructing level II- IV tumor thrombus without reconstruction of the inferior vena cava appears not to have a significant adverse effect on long-term renal function. Source of Funding: N/A © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e956 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Laura Horodyski More articles by this author Javier Gonzalez More articles by this author Marina Tabbara More articles by this author Jeffrey Gaynor More articles by this author Maria Rodriguez-Cabero More articles by this author Felipe Herranz-Amo More articles by this author Carlos Hernández More articles by this author Rushi Shah More articles by this author Gaetano Ciancio More articles by this author Expand All Advertisement PDF DownloadLoading ...