Research and Reports in Urology (Jun 2017)

Surgical intervention for renal cell carcinoma with inferior vena cava extension combined with laparoscopic procedure

  • Kamimura T,
  • Kida K,
  • Takeda M,
  • Sato S,
  • Fujii M,
  • Inoue M,
  • Tsukino H,
  • Mukai S,
  • Nanashima A,
  • Nakamura K,
  • Kamoto T

Journal volume & issue
Vol. Volume 9
pp. 107 – 112

Abstract

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Toshio Kamimura,1 Kazutaka Kida,1 Masashi Takeda,1 Shunsuke Sato,1 Masato Fujii,1 Masahiro Inoue,1 Hiromasa Tsukino,1 Shoichiro Mukai,1 Atsushi Nanashima,2 Kunihide Nakamura,2 Toshiyuki Kamoto1 1Department of Urology, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan; 2Department of Surgery, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan Abstract: Clear cell renal cell carcinoma (ccRCC) shows extreme hypervascularity, which may cause significant bleeding during surgery. For this reason, control of arterial blood supply is an important factor in the choice of operative procedure and in avoiding perioperative complications. This case series reports the successful dissection of renal artery in the preliminary stage of laparoscopic procedure in three ccRCC patients with inferior vena cava (IVC) extension. Patient 1 had right renal cell carcinoma (RCC) with level I tumor thrombus through two renal veins, and the renal artery was successfully dissected by retroperitonealscopic approach. Patient 2 had right invasive, immobilized RCC with significant infiltration to IVC and liver. Ligation of renal artery was performed by transperitoneal laparoscopic procedure. Patient 3 had left RCC with level III tumor thrombus and lung metastasis. Ligation of left renal artery and mobilization of peritoneal organs and kidney were performed by transperitoneal laparoscopic surgery. These cases suggest that combined laparoscopic-open surgery for RCC with IVC extension may facilitate early control of arterial blood supply. Keywords: renal cell carcinoma, IVC extension, combined laparoscopic-open surgery

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