Temporary filters and liver mobilization technique improve the safety and prognosis of radical nephrectomy and inferior vena cava thrombectomy in renal cell carcinoma with subdiaphragmatic thrombosis.
OBJECTIVE
This study aimed to investigate the safety and efficacy of preoperative temporary inferior vena cava (IVC) filter placement and intraoperative application of a liver mobilization technique.


METHODS
The experiment cohort of 42 cases and the control cohort of 36 cases of renal cell carcinoma involving the IVC were analyzed retrospectively. In the experiment cohort, patients were implanted with a temporary IVC filter as routine preoperative treatment. The control cohort of 36 cases received traditional radical nephrectomy + IVC thrombectomy.


RESULTS
In the experiment cohort, 42 cases did not show any symptom of tumor thrombus embolism perioperatively. The average operation time was 220 min and the average blood loss was 750 ml. Overall survival rate of improved surgery was significantly higher than traditional surgery (p = 0.0055). Moreover, tumor thrombus size and position was associated with overall survival (p = 0.0185).


CONCLUSIONS
Preoperative temporary IVC filter placement and intraoperative application of a liver mobilization technique to expose the IVC can effectively prevent tumor thrombosis embolism shedding and improve surgical safety.
Department of Urology, Zhongshan Hospital, Fudan University, Shanghai, PR China.
Jian-ping
JP
Zhang
Yu
Y
Zhu
Yu-jun
YJ
Liu
Li
L
Zhang
Li-an
LA
Sun
Jian-ming
JM
Guo
Zong-ming
ZM
Lin
D000368:Aged; D002292:Carcinoma, Renal Cell / Q000150:complications / Q000601:surgery*; D005260:Female; D006801:Humans; D007668:Kidney / Q000601:surgery; D007680:Kidney Neoplasms / Q000150:complications / Q000601:surgery*; D008099:Liver; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009360:Neoplastic Cells, Circulating / Q000473:pathology; D009392:Nephrectomy / Q000379:methods*; D011379:Prognosis; D012189:Retrospective Studies; D013514:Surgical Procedures, Operative; D017131:Thrombectomy / Q000379:methods*; D013923:Thromboembolism / Q000473:pathology; D013927:Thrombosis / Q000150:complications / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome; D014682:Vena Cava, Inferior / Q000601:surgery*