title: [Retroperitoneoscopic radical nephrectomy with inferior vena cava thrombectomy].
abstract: BACKGROUND
  Although laparoscopic radical nephrectomy has confidently established itself as the "gold standard" for treating renal cell carcinoma, reports on laparoscopic level II-III inferior vena cava (IVC) tumor thrombus thrombectomy are still lacking.
  
  
  METHODS
  From September 2013 through April 2015, three patients with renal cell carcinoma and level II IVC tumor thrombi underwent laparoscopic radical nephrectomy with IVC thrombectomy using a retroperitoneal approach. Tumor sized 10, 8, and 9 cm in the greatest dimension, the length of the IVC thrombi in proximal direction were 2.8, 4.1 and 3.5 cm, respectively.
  
  
  RESULTS
  In all patients, the endoscopic interventions were completed successfully without conversion to open surgery. Blood loss was less than 450 ml. No significant intraoperative or postoperative complications were observed. The patients were discharged from the hospital in satisfactory condition at days 19, 7 and 14, respectively. One patient with multiple lung and bone metastases died 11 months after the operation. The two other patients showed no signs of disease progression during the follow-up (16 and 35 months).
  
  
  CONCLUSIONS
  The retroperitoneal approach has certain advantages over the transperitoneal one. The method is relatively safe and reproducible. However, additional experience and further research are needed before the place of such operations in routine clinical practice can be assessed.
authors.affiliation: Volgograd State Medical University, Department of Urology.|Volgograd Regional Center for Uronephrology.
authors.forename: D V
authors.initials: DV
authors.lastname: Perlin
authors.affiliation: Volgograd State Medical University, Department of Urology.
authors.forename: V P
authors.initials: VP
authors.lastname: Zipunnikov
authors.affiliation: Volgograd State Medical University, Department of Urology.
authors.forename: I N
authors.initials: IN
authors.lastname: Dymkov
authors.affiliation: Volgograd Regional Center for Uronephrology.
authors.forename: A O
authors.initials: AO
authors.lastname: Shmanev
mesh_terms: D002292:Carcinoma, Renal Cell / Q000150:complications / Q000601:surgery*; D006801:Humans; D007680:Kidney Neoplasms / Q000150:complications / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods*; D017131:Thrombectomy / Q000379:methods*; D014682:Vena Cava, Inferior / Q000601:surgery*; D020246:Venous Thrombosis / Q000209:etiology / Q000601:surgery*
keywords: kidney cancer T3b; retroperitoneoscopic thrombectomy; tumor thrombus IVC