Cavectomy for the treatment of Wilms tumor with vascular extension

Cavectomy for the treatment of Wilms tumor with vascular extension

Author Ribeiro, R. C. Google Scholar
Schettini, Sergio T.omaz Autor UNIFESP Google Scholar
Abib, Simone de Campos Vieira Autor UNIFESP Google Scholar
Fonseca, José Honório de Almeida Palma da Autor UNIFESP Google Scholar
Cypriano, Monica Autor UNIFESP Google Scholar
Silva, Nasjla Saba da Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Abstract Purpose: Vascular extension to the vena cava occurs in 4% of Wilms tumor cases and can reach the right atrium in up to 1%. When this happens the thrombus is usually not adherent to the vessel wall, and there is blood flow around it. Preoperative chemotherapy can cause thrombus regression and even resolution. If the thrombus persists after chemotherapy, surgery will be a challenge. On the other hand, if the thrombus invades the vessel wall, its removal may not be feasible. in this situation cavectomy is a good surgical strategy because it provides complete resection. the prerequisite for cavectomy is the absence of blood flow in the vena cava on preoperative Doppler ultrasonography. We report 3 cases of Wilms tumor with vena caval invasion in which cavectomy was performed, and discuss the principles, indications and operative technique.Materials and Methods: A total of 171 patients with Wilms tumor were treated at our institution between 1984 and 2004. of these patients 6 with intravascular extension of thrombus within the right atrium were treated with extracorporeal. circulation, cardiac arrest and profound hypothermia, and 3 were treated with cavectomy.Results: There were no instances of surgical complications or postoperative renal failure in our patients who underwent cavectomy. All remain well and free of disease.Conclusions: Cavectomy is a safe procedure for treating pediatric patients with Wilms tumor when there is extension and invasion of the vena cava wall without blood flow.
Keywords Wilms tumor
vena cava
inferior
venous thrombosis
kidney neoplasms
Language English
Date 2006-07-01
Published in Journal of Urology. Philadelphia: Lippincott Williams & Wilkins, v. 176, n. 1, p. 279-283, 2006.
ISSN 0022-5347 (Sherpa/Romeo, impact factor)
Publisher Lippincott Williams & Wilkins
Extent 279-283
Origin http://dx.doi.org/10.1016/S0022-5347(06)00561-1
Access rights Closed access
Type Article
Web of Science ID WOS:000238298000067
URI http://repositorio.unifesp.br/handle/11600/29026

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