TY - JOUR
T1 - Perioperative Outcomes for Radical Nephrectomy and Level III-IV Inferior Vena Cava Tumor Thrombectomy in Patients with Renal Cell Carcinoma
AU - Vinzant, Nathan J.
AU - Christensen, Jon M.
AU - Smith, Mark M.
AU - Leibovich, Bradley C.
AU - Mauermann, William J.
N1 - Publisher Copyright:
© 2022 Elsevier Inc.
PY - 2022/8
Y1 - 2022/8
N2 - Objectives: This study examined the characteristics, intraoperative, and postoperative course of patients undergoing inferior vena cava tumor thrombectomy for metastatic renal cell carcinoma. Design: A single-center case series that reported demographic data and intraoperative and postoperative outcomes for patients with renal cell carcinoma undergoing inferior vena cava thrombectomy. Setting: This investigation was performed at a large quaternary referral center. Participants: Adult patients (age ≥18) admitted to the authors’ hospital from January 1, 2005, to March 10, 2017, undergoing inferior vena cava thrombectomy for level III and IV renal cell carcinoma. Interventions: No interventions were performed. Measurements and Main Results: Sixty-five patients who met the inclusion criteria were identified, with 31 patients diagnosed with level III and 34 with level IV renal cell carcinoma. Patients with level IV tumors were significantly more likely to have greater intraoperative blood loss, had longer surgical duration and hospital stays, and had more frequently required blood products, pressors, and cardiopulmonary bypass intraoperatively. Intraoperative transesophageal echo was more frequently used in level IV thrombectomy compared to level III (91.2% v 67.7%). Of patients with level IV thrombus, 41.2% developed postoperative atrial fibrillation compared to only 3.2% with level III thrombus. The 30-day mortality was 4.6% for both groups. Conclusions: Patients undergoing inferior vena cava tumor thrombectomy for renal cell carcinoma had more complex intraoperative and postoperative courses with level IV compared to level III tumor thrombus.
AB - Objectives: This study examined the characteristics, intraoperative, and postoperative course of patients undergoing inferior vena cava tumor thrombectomy for metastatic renal cell carcinoma. Design: A single-center case series that reported demographic data and intraoperative and postoperative outcomes for patients with renal cell carcinoma undergoing inferior vena cava thrombectomy. Setting: This investigation was performed at a large quaternary referral center. Participants: Adult patients (age ≥18) admitted to the authors’ hospital from January 1, 2005, to March 10, 2017, undergoing inferior vena cava thrombectomy for level III and IV renal cell carcinoma. Interventions: No interventions were performed. Measurements and Main Results: Sixty-five patients who met the inclusion criteria were identified, with 31 patients diagnosed with level III and 34 with level IV renal cell carcinoma. Patients with level IV tumors were significantly more likely to have greater intraoperative blood loss, had longer surgical duration and hospital stays, and had more frequently required blood products, pressors, and cardiopulmonary bypass intraoperatively. Intraoperative transesophageal echo was more frequently used in level IV thrombectomy compared to level III (91.2% v 67.7%). Of patients with level IV thrombus, 41.2% developed postoperative atrial fibrillation compared to only 3.2% with level III thrombus. The 30-day mortality was 4.6% for both groups. Conclusions: Patients undergoing inferior vena cava tumor thrombectomy for renal cell carcinoma had more complex intraoperative and postoperative courses with level IV compared to level III tumor thrombus.
KW - inferior vena cava tumor thrombectomy
KW - perioperative outcomes
KW - renal cell carcinoma
KW - transesophageal echo
UR - http://www.scopus.com/inward/record.url?scp=85130327058&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85130327058&partnerID=8YFLogxK
U2 - 10.1053/j.jvca.2022.04.023
DO - 10.1053/j.jvca.2022.04.023
M3 - Article
C2 - 35570081
AN - SCOPUS:85130327058
SN - 1053-0770
VL - 36
SP - 3093
EP - 3100
JO - Journal of Cardiothoracic and Vascular Anesthesia
JF - Journal of Cardiothoracic and Vascular Anesthesia
IS - 8
ER -