Caval Thrombus in Conjunction with Renal Tumors: Indication for Surgery and Technical Details

Patients with locally advanced renal cell carcinoma require an aggressive surgical approach, as this strategy represents the only hope for curing the disease. Selection of the appropriate surgical technique to treat these cases is essential in order to achieve the best outcomes. This process usually entails a tailored approach centered on the individual disease features. This article reviews the indications and provides a technical description for each of the surgical steps commonly used to address the multiple possible scenarios in this context

Improving surgical outcomes in renal cell carcinoma involving the inferior vena cava

Radical nephrectomy with tumor thrombectomy remains the mainstay of treatment in renal cell carcinoma with inferior vena cava extension. Despite the rapid improvements experienced in perioperative care in recent years, this intervention still often results in significant morbidity and mortality. A deeper understanding of salient features of this complex operation provides a valuable insight into the clinical mechanisms underlying the variations observed in surgical outcomes. The 'operation profile' serves not only as a basis for making an adequate prognostic assessment, but also creates a platform from which 'innovative' strategies for improving quality and safety can be made. The present review aims to set a 'profile' for radical nephrectomy and tumor thrombectomy, and to propose a number of strategies that may reduce the complication rates of this intervention