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Inferior Vena Cava (IVC) Resections without Reconstruction in Renal Tumors: Two Case Reports
Bogdan Moldovan1, Victor S Costache2,3, Irina Modrigan3
1'St. Constantin' Hospital, 500299 Brasov, Romania.
Diagnostics (Basel, Switzerland)
|May 27, 2023
Summary
Resection of the inferior vena cava (IVC) without reconstruction is a viable option for patients with extensive IVC thrombosis from renal tumors. This approach can lead to favorable outcomes and potentially long-term survival.
Area of Science:
- Oncology
- Vascular Surgery
- Nephrology
Background:
- Presents experience with inferior vena cava (IVC) resection without reconstruction in two patients with advanced renal tumors.
- Addresses challenges of IVC invasion and thrombosis by renal cell carcinoma and sarcoma.
Observation:
- Two cases of renal tumors with IVC invasion and thrombosis were treated with en bloc nephrectomy and IVC resection.
- One patient had right renal vein sarcoma; the other had clear cell renal carcinoma with left renal vein involvement.
- Both patients developed collateral circulation via the paravertebral plexus, enabling IVC resection without reconstruction.
Findings:
- Postoperative recovery was favorable with no major complications in both patients.
- Histopathology confirmed renal vein sarcoma and clear cell renal carcinoma.
- Survival was two years for the sarcoma case and two months for the clear cell renal carcinoma case.
Implications:
- IVC resection without reconstruction can be an alternative to complex reconstruction in selected cases of IVC thrombosis.
- This approach may mitigate risks associated with IVC reconstruction, such as further thrombosis.
- Offers a potentially life-extending option for patients with advanced renal malignancies involving the IVC.
