Related Experiment Video
Updated: May 16, 2025
05:11
Grade III Varicocele Surgical Treatment using Spermatic Vein-Superficial Abdominal Vein Shunt
Published on: August 23, 2024
260
Surgical Management of Tumours Invading the Inferior Vena Cava: A Delphi Consensus Document
Peter Balaz1, Adam Whitley2, Ivika Heinola3
1Division of Vascular Surgery, Department of General Surgery, University Hospital Královské Vinohrady, Prague, Czech Republic; Cardiocentre, Third Faculty of Medicine, Charles University, Prague, Czech Republic.
Summary
Expert consensus was established for managing retroperitoneal tumors involving the inferior vena cava (IVC). Key recommendations include CT imaging, IVC reconstruction for suprarenal involvement, and specific thrombectomy or resection strategies for IVC malignancy.
Area of Science:
- Vascular Surgery
- Surgical Oncology
- Medical Imaging
Background:
- Retroperitoneal malignancy involving the inferior vena cava (IVC) presents treatment challenges due to limited data and inconsistent management strategies.
- Establishing expert consensus is crucial for guiding surgical decisions in these complex cases.
Purpose of the Study:
- To establish an expert consensus on the surgical management of retroperitoneal tumors that involve the inferior vena cava (IVC).
Main Methods:
- A three-round Delphi project involving fourteen surgical experts.
- Data collection occurred between January 1, 2023, and December 15, 2023.
- Consensus was defined as 70% agreement, with statistical validation using Cronbach's α (0.05).
Main Results:
- Abdominal computed tomography (CT) is the gold standard for assessing IVC tumor invasion; CT-guided core needle biopsy is preferred for tissue diagnosis.
- Suprarenal IVC should be reconstructed, but not if chronically occluded with collateral circulation.
- Malignant thrombi without vessel wall involvement warrant thrombectomy; otherwise, IVC resection is recommended, preferably with an expanded polytetrafluoroethylene (ePTFE) prosthesis.
- IVC filters and arteriovenous fistulas are not recommended. Post-operative care includes therapeutic heparinization, mechanical compression, and routine CT angiography.
Conclusions:
- This expert consensus provides guidance for clinicians managing retroperitoneal tumors involving the IVC.
- The recommendations are based on limited literature and international expert experience, aiming to improve decision-making processes.
Related Concept Videos
01:18Veins of the Abdomen and Pelvis
393
The human body is a complex system of interconnected parts, and the circulatory system plays a crucial role in maintaining overall health. One key component of this system is the inferior vena cava, a large vein responsible for returning blood from the abdominopelvic viscera and abdominal walls to the heart.
The inferior vena cava is fed by numerous smaller veins. The lumbar veins, for instance, drain the posterior abdominal wall, emptying both directly into the inferior vena cava and into the...
The inferior vena cava is fed by numerous smaller veins. The lumbar veins, for instance, drain the posterior abdominal wall, emptying both directly into the inferior vena cava and into the...
393
01:28Esophageal Varices-II: Clinical Features and Management
31
Esophageal varices often manifest as gastrointestinal bleeding episodes, presenting symptoms like hematemesis (vomiting of blood), hematochezia (passing fresh blood via the rectum), and melena (black, tarry stools). Other signs can include weight loss, anorexia, abdominal discomfort, jaundice, pruritus, altered mental status, and muscle cramps.
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
31
01:11Overview of Systemic Veins
398
Systemic veins are crucial blood vessels that return deoxygenated blood from various body tissues back to the heart. There are three systemic veins that return deoxygenated blood to the heart, they are as follows.
The coronary sinus, the heart's principal vein, resides in the coronary sulcus on the heart's posterior aspect. This broad venous channel receives nearly all venous blood from the myocardium, the heart muscle. It is fed by three primary veins: the great cardiac vein, the...
The coronary sinus, the heart's principal vein, resides in the coronary sulcus on the heart's posterior aspect. This broad venous channel receives nearly all venous blood from the myocardium, the heart muscle. It is fed by three primary veins: the great cardiac vein, the...
398
01:19Veins of Thorax
421
The azygos system is a crucial part of the body's circulatory system and drains most of the thorax. It comprises the azygos, hemiazygos, and accessory hemiazygos veins.
The azygos vein, positioned just right of the midline and anterior to the vertebral column, begins at the junction of the right ascending lumbar and subcostal veins, terminating in the superior vena cava. This vein drains blood from the right side of the thoracic wall, thoracic viscera, and posterior abdominal wall.
The...
The azygos vein, positioned just right of the midline and anterior to the vertebral column, begins at the junction of the right ascending lumbar and subcostal veins, terminating in the superior vena cava. This vein drains blood from the right side of the thoracic wall, thoracic viscera, and posterior abdominal wall.
The...
421
01:21Inflammatory Bowel Disease V: Surgical Management
69
Surgical interventions for inflammatory bowel disease (IBD), which includes ulcerative colitis and Crohn's disease, are essential in managing symptoms and addressing complications. The selection of surgical procedures is contingent upon the specific conditions and complications that stem from these illnesses.
Here are some common surgical interventions for IBD:
Here are some common surgical interventions for IBD:
69