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Surgery for Renal Cell Carcinoma with Thrombus Extension into the Vena Cava

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Renal Cancer

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Abstract

The incidence of renal cell carcinoma continues to rise secondary to increased imaging utilization with the majority of new cases being lower stages based on size criteria. The incidence of larger renal tumors with known propensities for venous thrombus formation is still present and remains a challenge for the urological community in terms of surgical treatment with acceptable oncological outcomes and limited complications. Proper staging and preoperative imaging are crucial to determine the best approach with limited morbidity.

As previously described by multiple authors and institutions, the level of tumor thrombus is one if not the most important factor in determining the surgical approach. We detail our approach model and surgical technique in great detail with respect to thrombus within the renal vein, extending into the inferior vena cava and extending into the right atrium.

This chapter also provides data and technical descriptions from our contemporaries at other institutions describing alternative approaches. This latter section can be of utmost importance during any surgical procedures in which unanticipated complications can arise. We have also included our own personal experience with this patient population which is one of the largest within the urological community.

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Authors and Affiliations

  1. Department of Urology, Lahey Clinic, 41 Mall Road, Burlington, MA, 01805, USA

    Chad Wotkowicz M.D.

  2. Institute of Urology, Lahey Clinic, 41 Mall Road, Burlington, MD, 01805, USA

    John A. Libertino M.D.

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  1. Chad Wotkowicz M.D.
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  2. John A. Libertino M.D.
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Corresponding author

Correspondence to Chad Wotkowicz M.D. .

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Editors and Affiliations

  1. , Institute of Urology, Lahey Clinic, 41 Mall Road, Burlington, 01805, Massachusetts, USA

    John A Libertino

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Wotkowicz, C., Libertino, J.A. (2013). Surgery for Renal Cell Carcinoma with Thrombus Extension into the Vena Cava. In: Libertino, J. (eds) Renal Cancer. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-7236-0_15

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  • DOI: https://doi.org/10.1007/978-1-4614-7236-0_15

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  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4614-7235-3

  • Online ISBN: 978-1-4614-7236-0

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