title: Feasibility of Pure Conventional Retroperitoneal Laparoscopic Radical Nephrectomy With Level II Vena Caval Tumor Thrombectomy.
abstract: OBJECTIVE
  To report our surgical outcomes and experiences with pure conventional retroperitoneal laparoscopic nephrectomy and tumor thrombectomy for patients with right renal tumors and level II inferior vena caval tumor thrombus.
  
  
  METHODS
  From February 2012 to June 2014, five patients underwent pure conventional retroperitoneal laparoscopic nephrectomy and tumor thrombectomy. After the inferior vena cava was blocked using tourniquet loops above and below the thrombus with the contralateral renal vein being clamped, the inferior vena cava was opened, and the tumor thrombus was fully extracted.
  
  
  RESULTS
  The mean patient age was 57 years (43-71 years) and the mean body mass index was 22.44 kg/m(2) (20-25 kg/m(2)). The mean operative time was 241 minutes (180-300 minutes) and the mean estimated blood loss was 290 ml (50-1000 mL). The mean tumor size was 6.9 cm (3.5-9 cm) and the mean tumor thrombus length was 5.5 cm (4-10 cm). One patient needed an intraoperative transfusion, and the patient encountered bilateral lower limb deep vein thrombus. With a mean follow-up of 11.5 months (5-30 months), one patient was identified with lung metastasis 4 months postoperatively.
  
  
  CONCLUSIONS
  Although pure conventional laparoscopic nephrectomy and tumor thrombectomy for level II tumor thrombus are challenging, they are feasible in carefully selected patients. More studies are needed to confirm their superiority and oncologic outcomes.
authors.affiliation: Department of Urology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
authors.forename: Mingshuai
authors.initials: M
authors.lastname: Wang
authors.affiliation: Department of Urology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
authors.forename: Junhui
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Department of Urology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
authors.forename: Yinong
authors.initials: Y
authors.lastname: Niu
authors.affiliation: Department of Urology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China. Electronic address: xingnianzeng@hotmail.com.
authors.forename: Nianzeng
authors.initials: N
authors.lastname: Xing
mesh_terms: D000328:Adult; D000368:Aged; D005240:Feasibility Studies; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods*; D008875:Middle Aged; D009360:Neoplastic Cells, Circulating; D009392:Nephrectomy / Q000379:methods*; D012187:Retroperitoneal Space; D017131:Thrombectomy / Q000379:methods*; D014682:Vena Cava, Inferior