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• W2066723659 abstract "No AccessJournal of UrologyAdult urology1 Aug 2006Venacavoscopy During Nephrectomy for Renal Cell Carcinoma With Inferior Vena Caval Thrombus Benjamin Lowentritt, Michael W. Phelan, Paul S. VanZijl, Benjamin Philosophe, and Geoffrey N. Sklar Benjamin LowentrittBenjamin Lowentritt Financial interest and/or other relationship with Pfizer. More articles by this author , Michael W. PhelanMichael W. Phelan More articles by this author , Paul S. VanZijlPaul S. VanZijl More articles by this author , Benjamin PhilosopheBenjamin Philosophe More articles by this author , and Geoffrey N. SklarGeoffrey N. Sklar Financial interest and/or other relationship with Pfizer, Lilly-ICOS, Bayer, GlaxoSmithKline and Schering-Plough. More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2006.03.067AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Renal cell carcinoma with inferior vena caval thrombus remains a complex challenge for the urologist. Aggressive surgery to remove all tumor can result in long-term survival. Liver transplant techniques, assistance from cardiac surgeons and bypass techniques can yield optimal vascular control but there is still a blind element inside the inferior vena cava when the thrombus is evacuated. We present data on a technique using a flexible cystoscope to evaluate the lumen of the intrahepatic and suprahepatic inferior vena cava after nephrectomy and tumor thrombectomy. Materials and Methods: Seven patients underwent radical nephrectomy and tumor thrombectomy for renal cell carcinoma with inferior vena caval thrombus. During surgery and after removal of the tumor thrombus a flexible cystoscope was inserted into the venacavotomy for direct inspection of the inferior vena caval lumen. Any residual tumor was manipulated out of the lumen and removed. Patient records were reviewed for data on the time of this procedure, estimated blood loss, residual tumor, postoperative complications and survival. Results: Venacavoscopy required an average additional 5.6 minutes and residual tumor was found in 3 of 7 patients. Average estimated blood loss was 1,170 cc and it was not affected by venacavoscopy. One patient experienced acalculous cholecystitis, possibly as a result of this procedure. Mean followup was 17.6 months with 5 of 7 patients alive. Conclusions: Venacavoscopy is a safe, reliable method of intraoperative inspection of the inferior vena cava that uses equipment and techniques familiar to every urologist. This can help prevent incomplete thrombectomy and disastrous pulmonary embolus. 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Google Scholar 18 : Recurrence of renal cell carcinoma with extensive vena caval thrombus three years after radical nephrectomy. Urol Int2002; 68: 199. Google Scholar 19 : Application of the flexible cystoscope to the excision of renal cell carcinoma with intracaval tumor thrombus. Urology1995; 45: 671. Google Scholar University of Maryland School of Medicine, Baltimore, Maryland© 2006 by American Urological AssociationFiguresReferencesRelatedDetailsCited byWeiss R (2008) Editorial CommentJournal of Urology, VOL. 181, NO. 2, (498-499), Online publication date: 1-Feb-2009. Volume 176Issue 2August 2006Page: 468-471 Advertisement Copyright & Permissions© 2006 by American Urological AssociationKeywordskidneycarcinomaendoscopyvena cavarenal cellMetricsAuthor Information Benjamin Lowentritt Financial interest and/or other relationship with Pfizer. More articles by this author Michael W. Phelan More articles by this author Paul S. VanZijl More articles by this author Benjamin Philosophe More articles by this author Geoffrey N. Sklar Financial interest and/or other relationship with Pfizer, Lilly-ICOS, Bayer, GlaxoSmithKline and Schering-Plough. More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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• W2066723659 title "Venacavoscopy During Nephrectomy for Renal Cell Carcinoma With Inferior Vena Caval Thrombus" @default.
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