[Surgical therapy of tumor embolism of the vena cava in renal cell carcinoma].

Radical nephrectomy (Nx) with vena caval thrombectomy represents the only realistic chance of cure for patients with renal cell carcinoma with extension into the vena cava inferior (VCI). For stage III, with tumor extension in the retrohepatic VCI up to the diaphragm, a venous bypass technique is described. From July, 1996 through April, 1998, Nx combined with thrombectomy of the VCI was performed by isolation of the VCI, temporary occlusion of the hepatoduodenal ligament, and temporary extracorporal femoral-axillary veno-venous bypass with the Biomedicus pump. Radical resection of tumor thrombus from the VCI was accomplished under direct vision with minimal blood loss and without cardiopulmonary complications. With a follow-up of 21, 16, 9, 2, and 1 months, respectively, all patients are so far free of complications and without recurrent or metastatic disease.