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Intraoperative transesophageal echocardiography for inferior vena caval tumor thrombus in renal cell carcinoma
Author(s) -
OIKAWA TAKEHIRO,
SHIMAZUI TORU,
JOHRAKU AKIRA,
KIHARA SHINICHI,
TSUKAMOTO SADAMU,
MIYANAGA NAOTO,
HATTORI KAZUNORI,
KAWAI KOJI,
UCHIDA KATSUNORI,
TAKESHIMA HITOSHI,
SAITO SHIGEYUKI,
TOYOOKA HIDENORI,
AKAZA HIDEYUKI
Publication year - 2004
Publication title -
international journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.172
H-Index - 67
eISSN - 1442-2042
pISSN - 0919-8172
DOI - 10.1111/j.1442-2042.2003.00780.x
Subject(s) - medicine , inferior vena cava , renal cell carcinoma , thrombus , nephrectomy , radiology , balloon catheter , catheter , renal vein , surgery , balloon , kidney
Background : We investigated the advantages of intraoperative transesophageal echocardiography (TEE) during inferior vena caval tumor thrombectomy in renal cell carcinoma (RCC). Methods : Five patients with RCC that extended into the inferior vena cava (IVC) underwent radical nephrectomy. To remove the tumor thrombus in the IVC, an inflated Fogarty balloon catheter was used to pull the thrombus below the level of the hepatic veins with real‐time TEE monitoring. Results : In all cases, TEE monitoring during surgery provided an accurate and excellent view of the IVC thrombus. TEE was particularly helpful for the thrombectomy to minimize hepatic mobilization by using occlusion balloon catheter in two patients whose thrombus extended to the intrahepatic IVC. Conclusions : Intraoperative real‐time TEE monitoring is a safe, minimally invasive technique that can provide accurate information regarding the presence and extent of IVC involvement, guidance for placement of a vena caval clamp, confirmation of complete removal of the IVC thrombus and intervention using catheters to assist in thrombectomy.