What is it about?

We report for the first time intrapericardial control without CPB for radical nephrectomy with IVC (inferior vena cava) tumor thrombectomy.

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Why is it important?

Renal cell carcinoma (RCC) is unique among urologic tumors because of its potential for tumor thrombus formation and migration into the venous system. This develops in approximately 4% - 10% of cases (2) and some (2% - 10%) may extend up to the right atrium. RCCs are chemo- and radio-resistant, and due to the impending catastrophic nature of these tumors and also to recent advances in targeted therapy, an aggressive surgical approach has been advocated.


Radical nephrectomy and IVC tumor thrombectomy by intrapericardial control without CPB or hypothermic circulatory arrest is a safe and effective procedure for level Radical nephrectomy and IV infra-atrial tumor thrombi. This procedure can avoid serious intra- and postoperative complications while providing acceptable cancer-control and mortality results. This technique is also applicable for small non-adherent intraatrial tumor thrombi that are shrunk into the IVC after diseased renal artery ligation and can be milked downward before intrapericardial tourniquet placement.

Dr Mohammad Reza Safarinejad
University of Medical Sceices

Read the Original

This page is a summary of: Supradiaphragmatic Inferior Vena Caval Thrombectomy Without Cardiopulmonary Bypass: A Case Series at a Single Center, Nephro-Urology Monthly, July 2016, Kowsar Medical Institute,
DOI: 10.5812/numonthly.39726.
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