PTU - Polskie Towarzystwo Urologiczne
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Resection of inferior vena cava because of renal carcinoma tumor thrombus
Article published in Urologia Polska 2003/56/2.

authors

Marek Długosz, Adam Prażanowski, Andrzej Niewczas, Grzegorz Zarzycki
Oddział Urologiczny Szpitala Miejskiego w Ostrowcu Świętokrzyskim Ordynator: lek. med. Marek Długosz

keywords

renal, renal carcinoma, tumor thrombus, resection of inferior vena cava, neovascularisation

summary

Objectives. The aim of the study is to present the case ol\'a patient (female), who had resection of inferior vena cava (10-20 centimeters long section) because of tumor thrombus, it was not restoration of continuity of mentioned vein. It was imagined status of collateral circulation.
Material and method. 68 old years patient was treated with diagnosis of dexter renal carcinoma with tumor thrombus in venosus system in Department of Urology in Municipal Hospital in Ostrowiec Świętokrzyski. During the operation (nephrectomy) the tumor thrombus situated in inferior cava vein was found. Because of the difficulties during the operation which originated during resection tumor thrombus, it was decided to remove the mentioned (10- 20 centimeters long) section of inferior cava vein. The upper part of inferior cava vein was cut below ramification of renal vein sinister, the lower part of this vein - in the beginning of the connection with iliac veins. It was not restoration of continuity of vein. The hisl-pat examination: renal tumor - carcinoma clarocellularc renis typus solidus, thrombus-embolus carcinomatosus.
Results. Postoperative course was complicated by few days lasting respiratory-circulatory failure. It was also found the swelling of lower extremities. Inferior cavography was done four months after the operation and it showed that the contrast medium passes through from left to right side within the pelvis and further by ovary vein. The computer tomography found the extension of sinister ovary and renal vein. Biochemistry examinations did not find deviations from the norm. The swelling of lower extremities disappeared.
Conclusions. This kind of operation would never become as a standard treatment, nevertheless in some cases (selected patients) can be as a healing procedure.

references

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correspondence

Marek Długosz
ul. Wieniawskiego 14
27-400 Ostrowiec Świętokrzyski
tel.: (0-41) 247 8S 66: 0 606 46 55 2S