| Revue: | Revista médica de Chile |
| Base de datos: | PERIÓDICA |
| Número de sistema: | 000457899 |
| ISSN: | 0034-9887 |
| Autores: | Rojas, Pablo A1 Bravo, Juan Cristóbal1 Navarro, Renato1 Villagran, Sofía1 Zúñiga, Álvaro1 Troncoso, Pablo1 Becker, Pedro1 Briceño, Eduardo1 San Francisco, Ignacio F1 |
| Instituciones: | 1Pontificia Universidad Católica de Chile, Facultad de Medicina, Santiago de Chile. Chile |
| Año: | 2022 |
| Periodo: | Ago |
| Volumen: | 150 |
| Número: | 8 |
| Paginación: | 994-999 |
| País: | Chile |
| Idioma: | Español |
| Tipo de documento: | Artículo |
| Enfoque: | Aplicado, descriptivo |
| Resumen en inglés | Background: Vena cava (VC) involvement in kidney tumors occurs in 4 to 10% of cases, and is associated with a higher mortality. Nephrectomy with thrombectomy of the VC, performed by a multidisciplinary team, improves survival. Aim: To report a series of consecutive nephrectomies with caval thrombectomy performed in an academic center. Patients and Methods: We report 32 patients with cT3b and 3c renal tumors, who underwent radical nephrectomy with VC thrombectomy between 2001 and 2021. A descriptive analysis of clinical, surgical and pathological variables was performed. Overall survival (OS) and cancer-specific survival (CSS) was calculated using Kaplan-Meier curves. Results: The mean tumor size was 9.7 cm. According to Mayo classification 3/32 (9%) patients had a type I thrombus, 10/32 (31%) had a type II thrombus, 8/32 (25%) had a type III thrombus, and 5/32 (16%) had a type IV thrombus. The mean bleeding was 2000 cc. There was one intraoperative death. Nineteen percent of patients had complications >= 3 according to Clavien-Dindo classification. Reoperations occurred in 9%. Pre and postoperative creatinine levels were 1.17 and 1.91 mg/dl respectively (p < 0.01). Pre and postoperative Hematocrit levels were 47.9 and 31% respectively (p = 0.02). Sixty six percent of tumors were clear cell renal cancer, 9% were papillary and 3% were chromophobic. Mean OS was 10 months. Two-year SCE was 40%. Conclusions: Our results are similar to those reported elsewhere. Despite being an unusual pathology, the surgical technique has been improving, thanks to the multidisciplinary work of urologists and surgeons |
| Disciplinas: | Medicina |
| Palabras clave: | Nefrología, Cirugía, Nefrectomía radical, Trombectomía, Vena cava |
| Keyword: | Nephrology, Surgery, Radical nephrectomy, Thrombectomy, Cava vein |
| Texte intégral: | Texto completo (Ver HTML) Texto completo (Ver PDF) |
