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SURGICAL MANAGEMENT OF THE RENAL CANCER WITH THE TUMOR THROMBUS IN THE VENOUS SYSTEM T3B AND T3C


Authors: P. Morávek;  J. Dominik;  P. Habal;  P. Navrátil;  J. Pacovsky;  P. Žáček
Authors‘ workplace: FN a LF UK Hradec Králové ;  Urologická klinika
Published in: Urol List 2011; 9(4): 30-37

Overview

Surgical management of the renal cancer with the tumor thrombus in the venous system T3b and T3c re­presents exacting surgical procedure. Removing of the thrombus of the II and III level and especially level IV in the right heart atrium, is always associated with high risk of the peroperative and late complications. Indication to the surgery covers excluding organ and lymphatic metastases and good performance status. The most critical phase of the surgery is the securing the thrombus and its protection against its spontaneous tearing away with fatal consequences. The tumor thrombus extraction (level II to IV) is from the radicality and safety term suitable only in case of interdisciplinary collaboration of the urologist with the thoracic surgeon or the cardio surgeon.

Key words:
renal cell carcinoma, tumor thrombus, surgical management


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