[Retroperitoneoscopic radical nephrectomy with inferior vena cava thrombectomy]

Area of Science:

• Urology
• Surgical Oncology
• Minimally Invasive Surgery

Background:

• Laparoscopic radical nephrectomy is the standard for renal cell carcinoma.
• Laparoscopic inferior vena cava (IVC) tumor thrombectomy reports are limited, especially for level II-III thrombi.

Purpose of the Study:

• To evaluate the safety and efficacy of laparoscopic radical nephrectomy with IVC thrombectomy using a retroperitoneal approach for renal cell carcinoma with level II-III IVC tumor thrombi.

Main Methods:

• Three patients with renal cell carcinoma and level II-III IVC tumor thrombi underwent laparoscopic radical nephrectomy and IVC thrombectomy via a retroperitoneal approach.
• Tumor sizes ranged from 8-10 cm; IVC thrombi lengths were up to 4.1 cm.

Main Results:

• All procedures were completed laparoscopically without conversion to open surgery.
• Blood loss was minimal (<450 ml) with no significant intraoperative or postoperative complications.
• Two patients showed no disease progression at 16 and 35 months; one patient with metastases died at 11 months.

Conclusions:

• The retroperitoneal approach for laparoscopic IVC thrombectomy is safe and reproducible.
• This technique shows promise for treating renal cell carcinoma with IVC tumor thrombi.
• Further research and experience are needed to establish its routine clinical use.