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BMC Surgery
Published in: BMC Surgery 1/2023

Open Access 01-12-2023 | Kidney Cancer | Research

A novel technique for avoidance of sternotomy, diaphragmic incision and cardiopulmonary bypass during cavoatrial tumor thrombectomy for renal cell carcinoma with intraatrial tumor thrombus: a case series at a single center

Authors: Wei He, Zixiang Cong, Yaqing Liu, Zhongshun Yao, Fajuan Cheng, Yiming Zhang, Zhihong Niu

Published in: BMC Surgery | Issue 1/2023

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Abstract

Background

Radical nephrectomy with thrombectomy in patients with renal cell carcinoma (RCC) and level IV thrombus extending to the right atrium (RA) offers improved survival. However, this procedure is associated with significant perioperative morbidity and mortality. In this report, we describe a novel milking technique for patients with RA tumor thrombus using abdominal access, which does not require diaphragmic incision, sternotomy, right atriotomy, or cardiopulmonary bypass (CPB).

Methods

Between January 2019 and January 2022, four patients underwent resection of renal cell carcinoma extending into RA by a milking technique developed to avoid diaphragmic incision, sternotomy, or CPB. Patient characteristics, perioperative data, pathological features, and survival were evaluated.

Results

Complete resection was successful through pure transabdominal access without diaphragmic incision, sternotomy, or CPB in all patients.

Conclusion

We conclude that radical nephrectomy and thrombectomy in optimized cases with renal cell carcinoma extending into RA can be safely and effectively performed without diaphragmic incision, sternotomy, or CPB, avoiding serious perioperative complications while providing acceptable oncological outcomes.
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Metadata
Title
A novel technique for avoidance of sternotomy, diaphragmic incision and cardiopulmonary bypass during cavoatrial tumor thrombectomy for renal cell carcinoma with intraatrial tumor thrombus: a case series at a single center
Authors
Wei He
Zixiang Cong
Yaqing Liu
Zhongshun Yao
Fajuan Cheng
Yiming Zhang
Zhihong Niu
Publication date
01-12-2023
Publisher
BioMed Central
Published in
BMC Surgery / Issue 1/2023
Electronic ISSN: 1471-2482
DOI
https://doi.org/10.1186/s12893-023-02156-7

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