Right RCC with cavo-cardiac tumor thrombus

Abstract

Introduction: One of the unique features of RCC is the frequent pattern of growth intraluminally into the renal venous circulation in extreme cases this growth may extend into the inferior vena cava with cephaled migration in the heart. Material and method: It has been pur experience that an anterior surgical approach through c subcostal and pararectal incision provides excellent exposure for performing radical nephrectomy. A second cardio-vascular team, through a median sternotomy, canulated the ascending aorta ana the right atrium and cardiopulmonary bypass is initiated. The tumor thrombus is gently removed from the IVC. Results: In our department we performed more than 1305 radical nephrectomies for RCC. We have had 117 lateral or total IVC resection and in 8 cases we removed the thrombus from the right atrium. Conclusions: This approach allows such thrombus to be removed completely in a controlled operative setting that provides excellent exposure and reduces the potential for massive blood loss a major vascular injury.