Skip to main content

Open Radical Nephrectomy

  • Chapter
  • First Online:
Renal Cancer

Abstract

In this chapter we cover reasons for choosing open nephrectomy over minimally invasive surgery, the types of incision used to approach the kidney and a more descriptive section on the technical aspects of resection of renal tumours with IVC extension.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Devlin CM, Fowler S, Biyani CS, Forster JA. Changes in UK renal oncological surgical practice from 2008 to 2017: implications for cancer service provision and surgical training. BJU Int. n/a:n/a.

    Google Scholar 

  2. Neves RJ, Zincke H. Surgical treatment of renal cancer with vena cava extension. Br J Urol. 1987;59(5):390–5.

    Article  CAS  PubMed  Google Scholar 

  3. Abaza R. Initial series of robotic radical nephrectomy with vena caval tumor thrombectomy. Eur Urol. 2011;59(4):652–6.

    Article  PubMed  Google Scholar 

  4. Meng M. Urologic oncologic survey robotic level III inferior vena cava tumor thrombectomy: initial series. Gill IS, Metcalfe C, Abreu A, Duddalwar V, Chopra S, Cunningham M, Thangathurai D, Ukimura O, Satkunasivam R, Hung A, Papalia R, Aron M, Desai M, Gallucci M. J Urol. 2015 Oct;194(4):929-938. [Epub 2015 Apr 6]. Urol Oncol. 2017;35(5):311. https://doi.org/10.1016/j.juro.2015.03.119.

    Article  PubMed  Google Scholar 

  5. Wang B, Huang Q, Liu K, Fan Y, Peng C, Gu L, et al. Robot-assisted level III-IV inferior vena cava Thrombectomy: initial series with step-by-step procedures and 1-yr outcomes. Eur Urol. 2020;78(1):77–86.

    Article  CAS  PubMed  Google Scholar 

  6. Wein AJ, Kavoussi LR, Partin AW, Peters CA. Campbell-Walsh urology. 11th ed. Elsevier; 2016.

    Google Scholar 

  7. Jennings SB, Austenfeld MS, Basham K. Fatal pulmonary embolus from ischemic necrosis of Intracaval tumor thrombus: a case report. J Urol. 1993;150(5 Part 1):1492–5.

    Article  CAS  PubMed  Google Scholar 

  8. Subramanian VS, Stephenson AJ, Goldfarb DA, Fergany AF, Novick AC, Krishnamurthi V. Utility of preoperative renal artery embolization for management of renal tumors with inferior vena caval thrombi. Urology. 2009;74(1):154–9.

    Article  PubMed  Google Scholar 

  9. Ciancio G, Vaidya A, Soloway M. Early ligation of the renal artery using the posterior approach: a basic surgical concept reinforced during resection of large hypervascular renal cell carcinoma with or without inferior vena cava thrombus. BJU Int. 2003;92(4):488–9.

    Article  CAS  PubMed  Google Scholar 

  10. Chiavegato L, Medina-Pestana J, Tedesco-Silva H, Paisani D, Fiore J Jr, Faresin S. Surgical approach does not affect perioperative respiratory morbidity in living donor nephrectomy: comparison between anterior subcostal incision and flank incision. Transplant Proc. 2010;42(5):1472–5.

    Article  CAS  PubMed  Google Scholar 

  11. Hager B, Herzog SA, Sandner-Kiesling A, Zigeuner R, Pummer K. Comparison of early postoperative pain after partial tumour nephrectomy by flank, transabdominal or laparoscopic access. Br J Pain. 2019;13(3):177–84.

    Article  PubMed  Google Scholar 

  12. Kumar S, Duque JL, Guimaraes KC, Dicanzio J, Loughlin KR, Richie JP. Short and long-term morbidity of thoracoabdominal incision for nephrectomy: a comparison with the flank approach. J Urol. 1999;162(6):1927–9.

    Article  CAS  PubMed  Google Scholar 

  13. Honig MP, Mason RA, Giron F. Wound complications of the retroperitoneal approach to the aorta and iliac vessels. J Vasc Surg. 1992;15(1):28–33. Discussion -4

    Article  CAS  PubMed  Google Scholar 

  14. Ballard JL, Abou-Zamzam AM, Teruya TH, Harward TR, Flanigan DP. Retroperitoneal aortic aneurysm repair: long-term follow-up regarding wound complications and erectile dysfunction. Ann Vasc Surg. 2006;20(2):195–9.

    Article  PubMed  Google Scholar 

  15. Gardner GP, Josephs LG, Rosca M, Rich J, Woodson J, Menzoian JO. The retroperitoneal incision. An evaluation of postoperative flank 'bulge'. Arch Surg. 1994;129(7):753–6.

    Article  CAS  PubMed  Google Scholar 

  16. Purnell CA, Park E, Turin SY, Dumanian GA. Postoperative flank defects, hernias, and bulges: a reliable method for repair. Plast Reconstr Surg. 2016;137(3):994–1001.

    Article  CAS  PubMed  Google Scholar 

  17. Diblasio CJ, Snyder ME, Russo P. Mini-flank supra-11th rib incision for open partial or radical nephrectomy. BJU Int. 2006;97(1):149–56.

    Article  PubMed  Google Scholar 

  18. Jimenez-Torres JA, Virumbrales-Munoz M, Sung KE, Lee MH, Abel EJ, Beebe DJ. Patient-specific organotypic blood vessels as an in vitro model for anti-angiogenic drug response testing in renal cell carcinoma. EBioMedicine. 2019;42:408–19.

    Article  PubMed  PubMed Central  Google Scholar 

  19. O'Malley RL, Godoy G, Kanofsky JA, Taneja SS. The necessity of adrenalectomy at the time of radical nephrectomy: a systematic review. J Urol. 2009;181(5):2009–17.

    Article  PubMed  Google Scholar 

  20. González J, Ciancio G. Surgery of the inferior vena cava. Cham: Springer; 2017.

    Google Scholar 

  21. Blute ML, Leibovich BC, Lohse CM, Cheville JC, Zincke H. The Mayo Clinic experience with surgical management, complications and outcome for patients with renal cell carcinoma and venous tumour thrombus. BJU Int. 2004;94(1):33–41.

    Article  PubMed  Google Scholar 

  22. Blute ML, Boorjian SA, Leibovich BC, Lohse CM, Frank I, Karnes RJ. Results of inferior vena caval interruption by greenfield filter, ligation or resection during radical nephrectomy and tumor thrombectomy. J Urol. 2007;178(2):440–5. Discussion 4

    Article  PubMed  Google Scholar 

  23. Gershman B, Leibovich BC. Assessing the evidence for the surgical Management of Renal Cell Carcinoma with venous tumor thrombus: room to grow. Eur Urol. 2016;70(2):281–2.

    Article  PubMed  Google Scholar 

  24. Ayyathurai R, Garcia-Roig M, Gorin M, González J, Manoharan M, Kava B, et al. Bland thrombus association with tumour thrombus in renal cell carcinoma: analysis of surgical significance and role of inferior vena caval interruption. BJU Int. 2012;110

    Google Scholar 

  25. Psutka SP, Boorjian SA, Thompson RH, Schmit GD, Schmitz JJ, Bower TC, et al. Clinical and radiographic predictors of the need for inferior vena cava resection during nephrectomy for patients with renal cell carcinoma and caval tumour thrombus. BJU Int. 2015;116(3):388–96.

    Article  PubMed  Google Scholar 

  26. Dahan H, Arrivé L, Monnier-Cholley L, Le Hir P, Zins M, Tubiana JM. Cavoportal collateral pathways in vena cava obstruction: imaging features. AJR Am J Roentgenol. 1998;171(5):1405–11.

    Article  CAS  PubMed  Google Scholar 

  27. Abel EJ, Wood CG, Eickstaedt N, Fang JE, Kenney P, Bagrodia A, et al. Preoperative pulmonary embolism does not predict poor postoperative outcomes in patients with renal cell carcinoma and venous thrombus. J Urol. 2013;190(2):452–7.

    Article  PubMed  Google Scholar 

  28. O'Brien T, Fernando A, Thomas K, Van Hemelrijck M, Bailey C, Austin C. Raised preoperative international normalised ratio (INR) identifies patients at high risk of perioperative death after simultaneous renal and cardiac surgery for tumours involving the peri-diaphragmatic inferior vena cava and right atrium. BJU Int. 2017;119(3):424–9.

    Article  PubMed  Google Scholar 

  29. Shirodkar SP, Soloway MS, Ciancio G. Budd-Chiari syndrome in urology: impact on nephrectomy for advanced renal cell carcinoma. Indian J Urol. 2011;27(3):351–6.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Patil MB, Montez J, Loh-Doyle J, Cai J, Skinner EC, Schuckman A, et al. Level III-IV inferior vena caval thrombectomy without cardiopulmonary bypass: long-term experience with intrapericardial control. J Urol. 2014;192(3):682–8.

    Article  PubMed  Google Scholar 

  31. Baniel J, Foster RS, Donohue JP. Surgical anatomy of the lumbar vessels: implications for retroperitoneal surgery. J Urol. 1995;153(5):1422–5.

    Article  CAS  PubMed  Google Scholar 

  32. Smith JAJMD, Howards SSMD, Preminger GMMD, Dmochowski RRMDF. Copyright. In: Smith JAJMD, Howards SSMD, Preminger GMMD, RRMDF D, editors. Hinman’s atlas of urologic surgery; 2019. p. iv.

    Google Scholar 

  33. Libertino JA. Renal cancer: contemporary management. New York: Springer; 2013.

    Book  Google Scholar 

  34. Ciancio G, Soloway MS. Renal cell carcinoma with tumor thrombus extending above diaphragm: avoiding cardiopulmonary bypass. Urology. 2005;66(2):266–70.

    Article  PubMed  Google Scholar 

  35. Ciancio G, Shirodkar SP, Soloway MS, Livingstone AS, Barron M, Salerno TA. Renal carcinoma with supradiaphragmatic tumor thrombus: avoiding sternotomy and cardiopulmonary bypass. Ann Thorac Surg. 2010;89(2):505–10.

    Article  PubMed  Google Scholar 

  36. Kaag MG, Toyen C, Russo P, Cronin A, Thompson RH, Schiff J, et al. Radical nephrectomy with vena caval thrombectomy: a contemporary experience. BJU Int. 2011;107(9):1386–93.

    Article  PubMed  Google Scholar 

  37. Nguyen HG, Tilki D, Dall'Era MA, Durbin-Johnson B, Carballido JA, Chandrasekar T, et al. Cardiopulmonary bypass has no significant impact on survival in patients undergoing nephrectomy and level III-IV inferior vena cava Thrombectomy: multi-institutional analysis. J Urol. 2015;194(2):304–8.

    Article  PubMed  PubMed Central  Google Scholar 

  38. Abel EJ, Thompson RH, Margulis V, Heckman JE, Merril MM, Darwish OM, et al. Perioperative outcomes following surgical resection of renal cell carcinoma with inferior vena cava thrombus extending above the hepatic veins: a contemporary multicenter experience. Eur Urol. 2014;66(3):584–92.

    Article  PubMed  Google Scholar 

  39. Bower TC, Nagorney DM, Cherry KJ Jr, Toomey BJ, Hallett JW, Panneton JM, et al. Replacement of the inferior vena cava for malignancy: an update. J Vasc Surg. 2000;31(2):270–81.

    Article  CAS  PubMed  Google Scholar 

  40. Caldarelli G, Minervini A, Guerra M, Bonari G, Caldarelli C, Minervini R. Prosthetic replacement of the inferior vena cava and the iliofemoral vein for urologically related malignancies. BJU Int. 2002;90(4):368–74.

    Article  CAS  PubMed  Google Scholar 

  41. Morris PD, Furtado R, Pulitano C, Crawford M, Yeo D, Vasilaras A, et al. Inferior vena cava resection and reconstruction with bovine pericardium for renal cell carcinoma: complications and outcomes. Urology. 2019;134:143–7.

    Article  PubMed  Google Scholar 

  42. Tomimaru Y, Eguchi H, Wada H, Doki Y, Mori M, Nagano H. Surgical outcomes of liver resection combined with inferior vena cava resection and reconstruction with artificial vascular graft. Dig Surg. 2019;36(6):502–8.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to P. Brousil .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2022 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Brousil, P., Manson-Bahr, D., Stroman, L., O’Brien, T. (2022). Open Radical Nephrectomy. In: Anderson, C., Afshar, M. (eds) Renal Cancer . Springer, Cham. https://doi.org/10.1007/978-3-030-84756-2_10

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-84756-2_10

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-84755-5

  • Online ISBN: 978-3-030-84756-2

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics