Removal of inferior vena caval tumour thrombus: A simple technique

Surgical management of patients with renal cell carcinoma (RCC) with tumour extension into the inferior vena cava (IVC) poses a challenge when tumour thrombus extends into retro-hepatic or supra-hepatic IVC. Simple crass-clamping of the infrarenal IVC often causes a profound decrease in venous return with, at times, resultant hypotensive crisis. Though, several techniques have been described to manage such patients, they are either too cumbersome or demand extensive exposure and mobilization. We, hereby, report a simpler technique of en-bloc IVC tumour thrombectomy. In the last 7 years, nine patients of RCC with tumour extension into the IVC were operated by this technique, with minimal blood loss and no operative mortality. Three patients died later on, with local recurrence. Six patients, who are being followed up from 10 months to 57 months, are doing well. The technique is simple. It does not need elaborate setup and can be performed safely at any peripheral center.