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Surgery for Renal Cell Carcinoma with Thrombus Extension into the Vena Cava

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Renal Cancer

Abstract

The incidence of renal cell carcinoma continues to rise secondary to increased imaging utilization with the majority of new cases being lower stages based on size criteria. The incidence of larger renal tumors with known propensities for venous thrombus formation is still present and remains a challenge for the urological community in terms of surgical treatment with acceptable oncological outcomes and limited complications. Proper staging and preoperative imaging are crucial to determine the best approach with limited morbidity.

As previously described by multiple authors and institutions, the level of tumor thrombus is one if not the most important factor in determining the surgical approach. We detail our approach model and surgical technique in great detail with respect to thrombus within the renal vein, extending into the inferior vena cava and extending into the right atrium.

This chapter also provides data and technical descriptions from our contemporaries at other institutions describing alternative approaches. This latter section can be of utmost importance during any surgical procedures in which unanticipated complications can arise. We have also included our own personal experience with this patient population, which is one of the largest within the urological community.

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Author information

Authors and Affiliations

  1. Tufts University School of Medicine, Boston, MA, USA

    John A. Libertino & Jason R. Gee

  2. Department of Urology, MGH Cancer Center, Emerson Hospital, Concord, MA, USA

    John A. Libertino & Jason R. Gee

  3. Department of Urology, Lahey Clinic Medical Center, Burlington, MA, USA

    Chad Wotkowicz

Authors
  1. John A. Libertino
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  2. Chad Wotkowicz
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  3. Jason R. Gee
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Editor information

Editors and Affiliations

  1. Professor of Urology, Tufts University School of Medicine, Boston, MA, USA

    John A. Libertino

  2. Associate Professor of Urology, Tufts University School of Medicine, Boston, MA, USA

    Jason R. Gee

Electronic Supplementary Material

Novel technique for preoperative removal of intracardiac thrombus prior to radical nephrectomy and IVC thrombectomy (MP4 457875 kb)

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Libertino, J.A., Wotkowicz, C., Gee, J.R. (2020). Surgery for Renal Cell Carcinoma with Thrombus Extension into the Vena Cava. In: Libertino, J., Gee, J. (eds) Renal Cancer. Springer, Cham. https://doi.org/10.1007/978-3-030-24378-4_15

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  • DOI: https://doi.org/10.1007/978-3-030-24378-4_15

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-24377-7

  • Online ISBN: 978-3-030-24378-4

  • eBook Packages: MedicineMedicine (R0)

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