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Khirurgii

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Year 2021 Vol. 29 No 6

ONCOLOGY

I.I. KOBZA, YU.S. MOTA, R.A. ZHUK, YU.G. OREL

THE RESULTS OF SURGICAL MANAGEMENT FOR CàVOàTRIàL TUMOR THROMBOSIS DUE TO RENAL CELL CARCINOMA

Danylo Halytsky Lviv National Medical University, Lviv, Ukraine

Objective. Improvement the surgical management for càvoàtrial tumor thrombosis due to renal cell carcinoma.
Methods. The results of complex clinical, laboratory, instrumental examination, intraoperative observations and morphological studies were analyzed in 62 patients with renal cell carcinoma, complicated by cavîàtriàl tumor thrombosis, hospitalized to the vascular surgery department of Lviv rågionàl clinicàl hîspital for thå påriod 1993–2019. Surgical treatment included radical nephrectomy, thrombectomy from inferior vena cava and right atrium. Kaplan-Meier method was used to evaluate the long-term survival of patients.
Results. The postoperative complications included: posthemorrhagic anemia – 22 (38,6%), acute renal failure – 15 (26,3%), pulmonary embolism – 4 (7,0%), acute liver failure – 3 (5,3%), phlebothrombosis – 3 (5,3%), pneumonia – 3 (5,3%), stroke – 2 (3,5%), wound ñomplications – 5 (8,8%) cases. Perioperative mortality was 11,3%. The causes of death included: hemorrhagic shock – 4 (6,5%), pulmonary embolism – 3 (4,8%), stroke – 1 (1,6%) cases. Long-term survival indicators were evaluated among 53 patients. The median follow-up was 36,9±13,3 months. The cumulative 2-, 5-, and 10-year survivàl ràtes wårå 53,5%; 38,2% and 17,2%, in 32 pàtiånts without metastases – 58,7%; 43,1% and 18,5% råspåctivåly. Thårå wàs nî significànt diffåråncå ³in survivàl among patients with atrial and retrohepatic venous tumor thrombosis versus infrahepatic and cavarenal venous tumor thrombosis (p>0,05).
Conclusion. The accurate preoperative assessment of the level of neoprocess involvement, improvement of surgical tactics, effective prevention of thromboembolic and hemorrhagic complications make it possible to provide acceptable survival rates for patients with renal cell carcinoma, complicated by càvoàtrial tumor thrombosis.

Keywords: tumor thrombosis, inferior vena cava, right atrium, renal cell carcinoma, surgical treatment, results
p. 710-718 of the original issue
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Address for correspondence:
79010, Ukraine,
Lviv, Pekarska Str., 69,
Danylo Halytsky Lviv National
Medical University, Department of Surgery No2,
Tel. +38 096 837 99 25,
e-mail: yuliamota@gmail.com,
Mota Yuliya S.
Information about the authors:
Kobza Ihor I., MD, Professor, Head of the Surgery Department No2, Danylo Halytsky Lviv National Medical University, Lviv, Ukraine.
https://orcid.org/0000-0001-8493-414X
Mota Yuliya S., Post-Graduate Student of the Surgery Department No2, Danylo Halytsky Lviv National Medical University, Lviv, Ukraine.
https://orcid.org/0000-0002-6332-8404
Zhuk Rostyslav A., PhD, Associate Professor of the Surgery Department No2, Danylo Halytsky Lviv National Medical University, Lviv, Ukraine.
https://orcid.org/0000-0003-3605-0862
Orel Yuriy G., MD, Professor of the Surgery Department No2, Danylo Halytsky Lviv National Medical University, Lviv, Ukraine.
https://orcid.org/0000-0002-2283-7843
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