Drainage of the healthy-side renal vein during radical nephrectomy decreases the occurrence of postoperative renal dysfunction

概要

Purpose: Surgical resection of kidney cancer invading the inferior vena cava (IVC) remains technically challenging. The invasiveness of surgical procedure and postoperative renal dysfunction are major concerns. We present a surgical technique of tumor resection in patients with IVC invasion.
Methods: Tumors showed various extensions, including suprarenal and suprahepatic lesions. Tumors were resected via IVC isolation with cardiopulmonary bypass (CPB) in 10 patients, while extended hepatic mobilization and Pringle maneuver were performed when necessary. The last eight consecutive patients underwent healthy-side renal vein drainage using CPB during IVC clamping to avoid renal congestion and postoperative renal dysfunction; the first two patients were without healthy-side renal vein drainage.
Results: Surgical resection was achieved with acceptable mortality (10%). Postoperative renal function was well preserved in nine patients, except for one patient without renal vein drainage.
Conclusion: Radical resection of kidney cancer using healthy-side renal vein drainage helps preserve postoperative renal function.

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