Improving surgical outcomes in renal cell carcinoma involving the inferior vena cava.
Radical nephrectomy with tumor thrombectomy remains the mainstay of treatment in renal cell carcinoma with inferior vena cava extension. Despite the rapid improvements experienced in perioperative care in recent years, this intervention still often results in significant morbidity and mortality. A deeper understanding of salient features of this complex operation provides a valuable insight into the clinical mechanisms underlying the variations observed in surgical outcomes. The 'operation profile' serves not only as a basis for making an adequate prognostic assessment, but also creates a platform from which 'innovative' strategies for improving quality and safety can be made. The present review aims to set a 'profile' for radical nephrectomy and tumor thrombectomy, and to propose a number of strategies that may reduce the complication rates of this intervention.
Servicio de Urología, Hospital Central de la Cruz Roja San Joséy Santa Adela, Madrid, Spain.
Javier
J
González
Guillermo
G
Andrés
Juan Ignacio
JI
Martínez-Salamanca
Gaetano
G
Ciancio
D002292:Carcinoma, Renal Cell / Q000401:mortality / Q000601:surgery*; D017548:Echocardiography, Transesophageal / Q000379:methods; D004621:Embolization, Therapeutic; D006801:Humans; D007680:Kidney Neoplasms / Q000401:mortality / Q000601:surgery*; D009392:Nephrectomy / Q000379:methods*; D012077:Renal Artery; D017131:Thrombectomy / Q000379:methods; D016896:Treatment Outcome; D014682:Vena Cava, Inferior / Q000601:surgery*