title: Leiomyosarcoma of the inferior vena cava level II involvement: curative resection and reconstruction of renal veins.
abstract: Leiomyosarcoma of the inferior vena cava (IVCL) is a rare retroperitoneal tumor. We report two cases of level II (middle level, renal veins to hepatic veins) IVCL, who underwent en bloc resection with reconstruction of bilateral or left renal venous return using prosthetic grafts. In our cases, IVCL is documented to be occluded preoperatively, therefore, radical resection of tumor and/or right kidney was performed and the distal end of inferior vena cava was resected and without caval reconstruction. None of the patients developed edema or acute renal failure postoperatively. After surgical resection, adjuvant radiation therapy was administrated. The patients have been free of recurrence 2 years and 3 months, 9 months after surgery, respectively, indicating the complete surgical resection and radiotherapy contribute to the better survival. The reconstruction of inferior vena cava was not considered mandatory in level II IVCL, if the retroperitoneal venous collateral pathways have been established. In addition to the curative resection of IVCL, the renal vascular reconstruction minimized the risks of procedure-related acute renal failure, and was more physiologically preferable. This concept was reflected in the treatment of the two patients reported on.
authors: Department of General Surgery II, Jilin University First Hospital, Changchun, 130021, China.
authors: Quan
authors: Q
authors: Wang
authors: Jing
authors: J
authors: Jiang
authors: Chao
authors: C
authors: Wang
authors: Guodong
authors: G
authors: Lian
authors: Mei-Shan
authors: MS
authors: Jin
authors: Xueyuan
authors: X
authors: Cao
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D007890:Leiomyosarcoma / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures; D012082:Renal Veins / Q000601:surgery*; D019043:Vascular Neoplasms / Q000601:surgery*; D014656:Vascular Surgical Procedures / Q000379:methods*; D014682:Vena Cava, Inferior