Renal Function Preservation in Surgical Resection of Primary Inferior Vena Cava Leiomyosarcoma Involving the Renal Veins

Publication date: Available online 2 January 2018
Source:European Journal of Vascular and Endovascular Surgery
Author(s): Duan Liu, Hua-liang Ren, Bao Liu, Jiang Shao, Yue-xin Chen, Xiao-jun Song, Zhi-li Liu, Yu Chen, Yong-jun Li, Chang-wei Liu, Yue-hong Zheng
ObjectiveThis retrospective study aimed to show the practice of preserving renal function during curative resection of inferior vena cava leiomyosarcoma (IVCL) involving the renal veins at a single institution over a 7 year period.Materials and methodsFrom February 2009 to February 2017, 10 patients (6 women; median age 49 years) with IVCL involving the renal veins were treated surgically at Peking Union Medical College Hospital. En bloc resections were performed in all patients, and the renal outflows were preserved in eight patients using a new method: venoplasty of the renal ostia (VRO). Data regarding patient details, pre-operative preparation, surgical procedures, post-operative recovery, and follow-up results were obtained and reviewed retrospectively.ResultsComputed tomography and intra-operative examinations revealed that renal vein confluences were involved but not invaded in all cases except Patient 4. All patients underwent curative en bloc tumour excision; a right nephrectomy was performed in only one patient (Patient 4) whose tumour invaded the right renal vein. The mean operation time was 358 min and the mean blood loss 1935 mL. At a median follow-up of 54.5 months, the 5 year local recurrence, distant metastasis, overall survival, and disease-free survival rates were 20%, 10%, 68.6%, and 38.1%, respectively.ConclusionsVenoplasty of the renal ostia is an effective method of preserving the renal veins and reconstructing renal outflow.



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