[RADICAL LAPAROSCOPIC NEPHRECTOMY WITH INFERIOR VENA CAVA THROMBECTOMY]

Area of Science:

• Urology
• Surgical Oncology

Background:

• Renal cell carcinoma (RCC) is a common malignancy.
• Inferior vena cava (IVC) tumor thrombus complicates 5-10% of RCC cases.
• Laparoscopic approaches for IVC thrombectomy in RCC are rarely reported.

Observation:

• Two patients with RCC and level II IVC tumor thrombus underwent laparoscopic radical nephrectomy and IVC thrombectomy.
• Surgical technique involved IVC isolation, ligation of tributary veins, and controlled blood flow.
• The IVC defect was repaired with a continuous Prolene suture after thrombectomy.

Findings:

• Successful laparoscopic radical nephrectomy and IVC thrombectomy were achieved in both patients without conversion to open surgery.
• Follow-up of 6-18 months showed no local recurrence or distant metastasis.
• The procedure was deemed safe and reproducible for specific patient populations.

Implications:

• Laparoscopic radical nephrectomy with IVC thrombectomy is a viable option for select RCC patients with tumor thrombus.
• Minimally invasive surgery may offer advantages for complex RCC cases.
• Further studies are warranted to establish this technique broadly.