Intraoperative transesophageal sonographic monitoring of tumor thrombus in the inferior vena cava during radical nephrectomy and thrombectomy for renal cell carcinoma.
We report the case of a 58-year-old woman with renal cell carcinoma in whom real-time transesophageal sonographic monitoring of the tumor thrombus in the inferior vena cava provided dynamic information, allowing us to determine the appropriate operative procedure to use. Observation of the thrombus throughout the operation showed that mobilization of the liver resulted in compression of the inferior vena cava against the spine, increasing the risk of migration of the tumor thrombus and reinforcing the need to maintain adequate positioning of the liver to prevent such compression. The surgery was completed successfully, and the patient's postoperative course was uneventful. We recommend the use of real-time transesophageal sonographic monitoring of the tumor thrombus during such surgical procedures.
Tomita
Yoshihiko
Y
Division of Urology, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental Sciences, Asahimachi 1, Niigata 951-8510, Japan.
Kurumada
Shigenori
S
Takahashi
Kota
K
Ohzeki
Hajime
H
D002292:Carcinoma, Renal Cell / Q000150:complications* / Q000601:surgery*; D019160:Endosonography / Q000379:methods*; D004947:Esophagus / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000150:complications* / Q000601:surgery*; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D009392:Nephrectomy; D013927:Thrombosis / Q000000981:diagnostic imaging* / Q000209:etiology*; D014682:Vena Cava, Inferior / Q000000981:diagnostic imaging