Foley catheter-assisted six-step thrombectomy technique in the surgical management of renal cell carcinoma with Mayo level II to IV tumor thrombus. Issue 5 (May 2019)

• Record Type: Journal Article
• Authors: Liu, Zhuo; Tang, Shiying; Tian, Xiaojun; Zhang, Shudong; Wang, Guoliang; Zhang, Hongxian; Ma, Lulin
• Is Part Of: Journal of international medical research. Volume 47:Issue 5(2019)
• Page Start: 2104
• Page End: 2115
• Publication Date: 2019-05
• Subjects: Inferior vena cava -- Foley catheter-assisted six-step thrombectomy -- renal cell carcinoma -- tumor thrombus -- Mayo level -- surgical technique; Medicine -- Periodicals; Pharmacology -- Periodicals; 610.5
• DOI: 10.1177/0300060519836912
• Languages: English
• ISSNs: 0300-0605

Abstract

Objective: To simplify Foley catheter-assisted thrombectomy to a six-step approach and determine the feasibility and results of this technique for renal cell carcinoma (RCC) with a Mayo level II to IV tumor thrombus (TT). Methods: The surgical records of patients with RCC with a Mayo level II to IV TT treated in our hospital were retrospectively reviewed. Fifteen patients who underwent radical nephrectomy and thrombectomy with a Foley catheter-assisted procedure were included. Epidemiological and clinicopathological features, operation-related variables, and outcomes were evaluated. Results: The TTs in all 15 patients were successfully retracted by the Foley catheter. The mean operation time was 420.1 ± 108.9 minutes. The mean intraoperative blood loss and perioperative red blood cell transfusion volumes were 1846.7 ± 1467.8 and 1288.7 ± 1060.6 mL, respectively. Five patients had perioperative complications. The median follow-up time was 9 (range, 0–34) months, and four patients died of the disease. Conclusions: Simplification of Foley catheter-assisted thrombectomy to a six-step approach results in the probability of avoiding thoracotomy or cardiopulmonary bypass to a certain degree and is associated with fewer complications, less blood loss, and less perioperative red blood cell transfusion. However, experienced surgeons and multidisciplinary cooperation are still needed.