title: End-to-end renal vein anastomosis to preserve renal venous drainage following inferior vena cava radical resection due to leiomyosarcoma.
abstract: BACKGROUND
  When retrohepatic inferior vena cava (IVC) resection is required, for example, for IVC leiomyosarcoma, reconstruction is recommended. This is particularly true when the renal vein confluence is resected to preserve venous outflow, including that of the right kidney.
  
  
  METHODS
  Two patients with retrohepatic IVC leiomyosarcoma involving renal vein confluences underwent hepatectomy with en bloc IVC resection below the renal vein confluence. IVC reconstruction was not performed, but end-to-end renal vein anastomoses were, including a prosthetic graft in 1 case.
  
  
  RESULTS
  The postoperative course was uneventful with respect to kidney function, anastomosis patency assessed using Doppler ultrasonography and computerized tomography, and transient lower limb edema.
  
  
  CONCLUSIONS
  End-to-end renal vein anastomosis after a retrohepatic IVC resection including the renal vein confluence should be considered as an alternative option for preserving right kidney drainage through the left renal vein when IVC reconstruction is not possible or should be avoided.
authors: Department of Gastroenterology, University of Sao Paulo School of Medicine, São Paulo, Brazil.
authors: Raphael L C
authors: RL
authors: Araujo
authors: Department of Hepato-Pancreato-Biliary Surgery, Pôle des Maladies de l'Appareil Digestif (PMAD), AP-HP, Beaujon Hospital, Clichy, France; University Paris 7 Denis Diderot, Paris, France.
authors: Sébastien
authors: S
authors: Gaujoux
authors: Department of Gastroenterology, University of Sao Paulo School of Medicine, São Paulo, Brazil.
authors: Luiz Augusto Carneiro
authors: LA
authors: D'Albuquerque
authors: Department of Hepato-Pancreato-Biliary Surgery, Pôle des Maladies de l'Appareil Digestif (PMAD), AP-HP, Beaujon Hospital, Clichy, France; University Paris 7 Denis Diderot, Paris, France.
authors: Alain
authors: A
authors: Sauvanet
authors: Department of Hepato-Pancreato-Biliary Surgery, Pôle des Maladies de l'Appareil Digestif (PMAD), AP-HP, Beaujon Hospital, Clichy, France; University Paris 7 Denis Diderot, Paris, France.
authors: Jacques
authors: J
authors: Belghiti
authors: Department of Gastroenterology, University of Sao Paulo School of Medicine, São Paulo, Brazil. Electronic address: wellington@usp.br.
authors: Wellington
authors: W
authors: Andraus
mesh_terms: D000328:Adult; D000714:Anastomosis, Surgical; D019917:Blood Vessel Prosthesis Implantation; D003097:Collateral Circulation; D017809:Fatal Outcome; D005260:Female; D006498:Hepatectomy; D006801:Humans; D007890:Leiomyosarcoma / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D009361:Neoplasm Invasiveness; D016577:Pancreaticoduodenectomy; D012079:Renal Circulation; D012082:Renal Veins / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D019043:Vascular Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D014656:Vascular Surgical Procedures; D014682:Vena Cava, Inferior / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*