International Medical Journal, Vol. 20., Iss. 1, 2014, P. 61−64.
CONTROL OF RENAL ARTERY AT REMOVAL OF TUMOR THROMBI FROM THE LUMEN OF THE INFERIOR VENA CAVA: SURGICAL STRATEGY OPTIONS
Kharkiv National Medical University;V.I. Shapoval Regional Center of Urology and Nephrology, Kharkiv
The author analyzes various methods of control of renal artery at caval thrombectomy. Based on research findings on this problem and own surgical experience he discusses the advantages and disadvantages of preliminary bandaging of the renal artery, pre−operative renal artery embolization and artery bandage after thrombectomy. The priorities of thrombectomy before the renal artery ligation including high safety in respect of the thrombus fragmentation and embolism with the tumor of the pulmonary artery as well as massive bleeding from renal venous collaterals are presented. Nevertheless this surgical approach can increase venous hypertension inside the kidney and its influence on cancer results require further clinical investigation. An ideal method of renal artery control at venocavothrombectomy does not exist at present. This stage of the operation considerably depends on the experience and individual preferences of the surgeon. Further investigation is necessary to determine the role of the existing surgical techniques.
Key words: ligation of the renal artery, renal artery embolization, tumor thrombus, inferior vena cava.