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Surgical intervention for renal cell carcinoma with inferior vena cava extension combined with laparoscopic procedure

Authors Kamimura T, Kida K, Takeda M, Sato S, Fujii M, Inoue M, Tsukino H, Mukai S, Nanashima A, Nakamura K, Kamoto T

Received 15 February 2017

Accepted for publication 11 April 2017

Published 19 June 2017 Volume 2017:9 Pages 107—112


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Dr Jan Colli

Toshio Kamimura,1 Kazutaka Kida,1 Masashi Takeda,1 Shunsuke Sato,1 Masato Fujii,1 Masahiro Inoue,1 Hiromasa Tsukino,1 Shoichiro Mukai,1 Atsushi Nanashima,2 Kunihide Nakamura,2 Toshiyuki Kamoto1

1Department of Urology, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan; 2Department of Surgery, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan

Abstract: Clear cell renal cell carcinoma (ccRCC) shows extreme hypervascularity, which may cause significant bleeding during surgery. For this reason, control of arterial blood supply is an important factor in the choice of operative procedure and in avoiding perioperative complications. This case series reports the successful dissection of renal artery in the preliminary stage of laparoscopic procedure in three ccRCC patients with inferior vena cava (IVC) extension. Patient 1 had right renal cell carcinoma (RCC) with level I tumor thrombus through two renal veins, and the renal artery was successfully dissected by retroperitonealscopic approach. Patient 2 had right invasive, immobilized RCC with significant infiltration to IVC and liver. Ligation of renal artery was performed by transperitoneal laparoscopic procedure. Patient 3 had left RCC with level III tumor thrombus and lung metastasis. Ligation of left renal artery and mobilization of peritoneal organs and kidney were performed by transperitoneal laparoscopic surgery. These cases suggest that combined laparoscopic-open surgery for RCC with IVC extension may facilitate early control of arterial blood supply.

Keywords: renal cell carcinoma, IVC extension, combined laparoscopic-open surgery

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