Reno-Gonadal Venous Anastomosis for Right Renal Venous Drainage Following Juxtarenal Cavectomy for Renal Cell Carcinoma

Jabrina Simmons

Division of Urologic Oncology, The Ohio State University Comprehensive Cancer Center, Columbus, OH


Tae-Hee Kim

Division of Urologic Oncology, The Ohio State University Comprehensive Cancer Center, Columbus, OH


Tasha Posid

Division of Urologic Oncology, The Ohio State University Comprehensive Cancer Center, Columbus, OH


Shawn Dason

Division of Urologic Oncology, The Ohio State University Comprehensive Cancer Center, Columbus, OH


Keywords

inferior vena cava tumor thrombus, juxtarenal cavectomy, renal cell carcinoma, reno-gonadal drainage, vascular reconstruction

Abstract

This article is a case report of a 62-year-old male with a left-sided renal cell carcinoma (RCC) with a level II inferior vena cava (IVC) thrombus and caval occlusion. He was managed with open left radical nephrectomy and juxtarenal cavectomy. To preserve right renal venous drainage, the right renal vein was anastomosed to the right gonadal vein. He has not had any renal functional decline or disease recurrence with 3 years of follow-up. The focus of this article is to discuss this distinctive method for vascular reconstruction as an option for right renal venous drainage following left nephrectomy and juxtarenal cavectomy.

References

1. Ansel AL, Johnson JM. Prevention and management of polytetrafluoroethylene graft complications in peripheral vascular reconstruction. Am J Surg. 1982;144(2):228–30. https//doi.org/10.1016/0002-9610(82)90514-1. PMID: 7102931.
2. Bahadoram S, Davoodi M, Hassanzadeh S, Bahadoram M, Barahman M, Mafakher L. Renal cell carcinoma: An overview of the epidemiology, diagnosis, and treatment. G Ital Nefrol. 2022;39(3): PMID: 35819037.
3. Benkirane A, Khodari M, Yakoubi R, Lambert M, Koussa M, Ghoneim T, et al. Polytetrafluoroethylene expanded prosthesis as replacement of the inferior vena cava in renal cell carcinoma with caval thrombus. Int J Urol. 2014;21(5):448–52. https//doi.org/10.1111/iju.12339. PMID: 24528332.
4. Ciancio G. Inferior vena cava reconstruction using a ringed polytetrafluoroethylene interposition graft and inferior vena cava filter placement following resection of renal cell carcinoma with a tumor thrombus directly infiltrating the inferior vena cava. Vasc Endovascular Surg. 2022;56(1):5–10. https//doi.org/10.1177/15385744211037602. PMID: 34372714.
5. Dason S. V11-06: The open abdominal approach to level III/IV vena caval tumor thrombi with caval obstruction. J Urol [Internet]. 2021;206(Supplement 3):e859. Available from: https://doi.org/10.1097/JU.0000000000002073.06
6. Dason S, Mohebali J, Blute ML, Salari K. Surgical management of renal cell carcinoma with inferior vena cava tumor thrombus. Urol Clin North Am. 2023;50(2):261–84. https//doi.org/10.1016/j.ucl.2023.01.007. PMID: 36948671.
7. Du S, Huang Q, Yu H, Shen D, Gu L, Yan F, et al. Initial series of robotic segmental inferior vena cava resection in left renal cell carcinoma with caval tumor thrombus. Urology. 2020;142:125–32. https//doi.org/10.1016/j.urology.2020.03.053. PMID: 32339559.
8. Ray S, Singer EA, Dason S. Inferior vena cava thrombectomy for renal cell carcinoma: perioperative systemic therapy, cytoreductive nephrectomy, and complex cases. Ann Transl Med. 2023;11(6):239. https//doi.org/10.21037/atm-23-1073. PMID: 37082664; PMCID: PMC10113102.
9. González J, Gorin MA, Garcia-Roig M, Ciancio G. Inferior vena cava resection and reconstruction: Technical considerations in the surgical management of renal cell carcinoma with tumor thrombus. Urol Oncol. 2014;32(1):34.e19–26. https//doi.org/10.1016/j.urolonc.2013.01.004. PMID: 23499500.

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