Intraoperative transesophageal echocardiography for inferior vena caval tumor thrombus in renal cell carcinoma |
| |
Authors: | TAKEHIRO OIKAWA TORU SHIMAZUI AKIRA JOHRAKU SHINICHI KIHARA SADAMU TSUKAMOTO NAOTO MIYANAGA KAZUNORI HATTORI KOJI KAWAI KATSUNORI UCHIDA HITOSHI TAKESHIMA SHIGEYUKI SAITO HIDENORI TOYOOKA HIDEYUKI AKAZA |
| |
Affiliation: | Department of Urology, Institute of Clinical Medicine, University of Tsukuba, Tsukuba-City, Ibaraki, Japan. |
| |
Abstract: | BACKGROUND: We investigated the advantages of intraoperative transesophageal echocardiography (TEE) during inferior vena caval tumor thrombectomy in renal cell carcinoma (RCC). METHODS: Five patients with RCC that extended into the inferior vena cava (IVC) underwent radical nephrectomy. To remove the tumor thrombus in the IVC, an inflated Fogarty balloon catheter was used to pull the thrombus below the level of the hepatic veins with real-time TEE monitoring. RESULTS: In all cases, TEE monitoring during surgery provided an accurate and excellent view of the IVC thrombus. TEE was particularly helpful for the thrombectomy to minimize hepatic mobilization by using occlusion balloon catheter in two patients whose thrombus extended to the intrahepatic IVC. CONCLUSIONS: Intraoperative real-time TEE monitoring is a safe, minimally invasive technique that can provide accurate information regarding the presence and extent of IVC involvement, guidance for placement of a vena caval clamp, confirmation of complete removal of the IVC thrombus and intervention using catheters to assist in thrombectomy. |
| |
Keywords: | Fogarty catheter IVC thrombus renal cell carcinoma transesophageal echocardiography |
|
|