Treatment of kidney-cell cancer of combined metatrombosis of kidney and cava vein

Abstract

A retrospective analysis of the results of surgical treatment of 12 patients with renal cell carcinoma (NKR) complicated by metatrombosis of the renal and lower void (NI) in the period from 2016 to 2018 is presented. All patients were selected on the basis of the presence of meta thrombosis in the veins of the lower void system, which poses certain risks of thromboembolic complications in the treatment. It is thromboembolic complications in the treatment of this type of cancer are the main cause of mortality in this group of patients. We estimated the level of proliferation of renal vein occlusion and NIP according to the classification of the Mayo Clinic by modification (Ciancio et al., 2002). The transition of the thrombotic process to the lower vena cava has long been the reason for the abandonment of the surgical treatment of such patients, so in our clinic, we applied a multidisciplinary approach to the treatment of this category of patients with renal cell carcinoma. In one case, there was a combination of meta thrombosis with aneurysm of the infra-red part of the abdominal aorta without rupture. All patients in this group were treated surgically. A satisfactory result was noted in 9 (75%) patients with this pathology, which made it possible to achieve satisfactory results taking into account the long-term results of complex treatment of patients with renal cellular cancer. Various complications arose in 3 (25%) patients. In the development of complications, the whole complex of intensive conservative therapy was used, including thrombolytic therapy for thromboembolic complications. Mortality was 2 cases (16.6%). The main causes of death are fragmentation of the thrombus, which causes pulmonary embolism and massive bleeding with the development of acute heart failure. The period of observation in our institution ranged from 2 to 33 months. Two-year survival has been confirmed at 66.6%.