World Journal of Surgery

, Volume 39, Issue 5, pp 1294–1300 | Cite as

Clinical Outcomes Related to the Level of Clamping in Inferior Vena Cava Surgery

  • Heungman Jun
  • Youngjin Han
  • Hojong Park
  • Sung Shin
  • Yong-Pil Cho
  • Tae-Won Kwon
Original Scientific Report
First Online:

Abstract

Objective

In most cases of inferior vena cava (IVC) surgery, IVC clamping is required owing to several factors, including renal cell carcinoma with IVC thrombus extension and IVC leiomyosarcoma. Various clinical results were compared following IVC clamping by classifying clamping levels into juxtarenal, infrahepatic, and suprahepatic. In particular, the risk factors of postoperative thrombosis after IVC clamping were assessed comparatively.

Methods

Eighty-four patients who underwent IVC clamping owing to IVC pathology between 2002 and 2012 were retrospectively reviewed with regard to RBC transfusion, operation time, clamping time, liver and kidney functions, duration of hypotension, blood pressure (BP) drops, pulmonary thromboembolism (PTE), venous thrombosis, ICU stay duration, hospital stay duration, 30-day morbidity, and 30-day mortality. In addition, various clinical results were compared when postoperative thrombosis occurred after IVC clamping.

Results

Values for operation time, clamping time, units of RBC transfused, duration of hypotension, severity of BP drops, use of cardiopulmonary bypass (CPB), aspartate aminotransferase, the use of inotropes, IVC patency, ICU stay, and hospital stay duration were significantly higher in the suprahepatic clamping group than in the other clamping groups. In addition, CPB use and IVC clamping level were significant risk factors for postoperative thrombosis after IVC clamping.

Conclusions

Although IVC clamping is a prerequisite for IVC surgery, operative durations, units of RBC transfused, and length of hospital stays increase with higher clamping levels. In addition, CPB use and IVC clamping level are significant risk factors for postoperative thrombosis. In IVC surgery with higher clamping levels, prompt hemodynamic support and proper anticoagulation therapy are important.

Keywords

Renal Cell Carcinoma Inferior Vena Cava Acute Kidney Injury Blood Pressure Drop Inferior Vena Cava Thrombus 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
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Copyright information

© Société Internationale de Chirurgie 2015

Authors and Affiliations

  • Heungman Jun
    • 1
  • Youngjin Han
    • 2
  • Hojong Park
    • 3
  • Sung Shin
    • 2
  • Yong-Pil Cho
    • 2
  • Tae-Won Kwon
    • 2
  1. 1.Division of Transplantation and Vascular Surgery, Department of SurgeryKorea University Anam HospitalSeoulKorea
  2. 2.Division of Vascular Surgery, Department of Surgery, Asan Medical CenterUniversity of Ulsan College of MedicineSeoulKorea
  3. 3.Department of Surgery, Ulsan University HospitalUniversity of Ulsan College of MedicineUlsanKorea

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