The Analysis of Postoperative Complications after Thrombectomy From Inferior Vena Cava in Renal Cell Carcinoma

Atduev V.A., Amoev Z.V., Belsky V.A., Abramov D.V., Beryozkina G.A., Rykhtik P.I., Shatokhina I.V.

Key words: renal cell carcinoma, tumour thrombus, inferior vena cava, operative therapy, complications.

2012, issue 2, page 51.

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The aim of the investigation is to analyze the results of thrombectomy from inferior vena cava in renal cell carcinoma to reveal the main prognostic factors of postoperative complications.

Materials and Methods. Nephrectomy with thrombectomy from inferior vena cava was performed in 34 patients. Thrombus level Т_3b was revealed in 27 patients (79.4%) (thrombus length — 5.10±1.75 cm), Т_3с — in 7 patients (20.6%) (thrombus length — 14.80±0.98 см). Postoperative complications were analyzed according to Clavien–Dindo classification of surgical complications.

Results. Blood loss volume in operation was on average 866 ml (250–4000 ml). 18 patients (52.9%) had no complications. Two patients (5.9%) had I degree complication (anemia). The II degree of complication was revealed in 11 patients (32.3%), after the operation they underwent blood transfusion. One patients (2.9%) had IIIa degree of complications (after the operation he required pleural punctures and pericardium drainage under local anesthesia), and one patients had IIIв degree of complications (descending colon perforation) — he underwent relaparotomy and colostomy. There were no IV degree complications. One patient (2.9%) died (V degree) from pulmonary embolism. Correlation analysis determined high (r=0.7) complications dependence of thrombus size and blood loss volume (r=0.6) and low dependence — of tumour size (r=0.44). There were revealed no complication dependence of patients age (r=0.1), status on Karnofsky scale (r=0.0). All 33 patients discharged from hospital had lived over 6 months after the operation.

Conclusion. After nephrectomy with thrombectomy from inferior vena cava there is high risk of postoperative complications, the frequency and type of which to a greater degree depend on thrombus size and blood loss volume.

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Atduev V.A., Amoev Z.V., Belsky V.A., Abramov D.V., Beryozkina G.A., Rykhtik P.I., Shatokhina I.V. The Analysis of Postoperative Complications after Thrombectomy From Inferior Vena Cava in Renal Cell Carcinoma. Sovremennye tehnologii v medicine 2012; (2): 51