Téma: 

Surgical removal of renal cell carcinoma with tumor thrombus in the right atrium results of the therapy (1993 - 2006)

Petr Morávek, Jan Dominik

Objectives: Radical removal of renal cell carcinoma with tumor thrombus in the right atrium (stage T3b) encourages attention of urologists. At present in view of surgery strategy, intra and postoperative mortality and morbidity, therapeutic results, the optimal management remains unsolved. The authors review their own 15- year experience. Material and method: Abdominal approach to removal of the kidney and exposure of the vena cava inferior was conducted in study group of 17 patients who underwent surgery in years 1993 - 2006 Next step were sternotomy with cardiopulmonary bypass (CPB), removal thrombus via right atriotomy and cavotomy in deep hypothermia (20 - 18 oC) with cardiac arrest. Results: The hospitalization mortality rate was 11.2 % (2 patients), the 3-year survival rate was 33 % and 5-year survival rate was 27 %. Conclusion: In correct indication (T3c, N0, M0) the authors consider the removal of the thrombus as part of radical nephrectomy and chosen method relatively safe as for the patient so for the surgeon.

Ročník 2006  Témy časopisu Clinical urology 3 / 2006

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