Produção Nacional
Revisado por pares
Cavectomy for the Treatment of Wilms Tumor With Vascular Extension
2006; Lippincott Williams & Wilkins; Volume: 176; Issue: 1 Linguagem: Inglês
10.1016/s0022-5347(06)00561-1
ISSN1527-3792
AutoresRodrigo Chaves Ribeiro, Sergio Crescenzo Antonio Schettini, Simone de Campos Vieira Abib, José Honório Palma da Fonseca, Mônica Cypriano, Nasjla Saba da Silva,
Tópico(s)Tuberous Sclerosis Complex Research
ResumoNo AccessJournal of UrologyPediatric urology1 Jul 2006Cavectomy for the Treatment of Wilms Tumor With Vascular Extension Rodrigo Chaves Ribeiro, Sergio Tomaz Schettini, Simone de Campos Vieira Abib, José Honório Palma da Fonseca, Mônica Cypriano, and Nasjla Saba da Silva Rodrigo Chaves RibeiroRodrigo Chaves Ribeiro Department of Pediatric Surgery, Pediatric Oncology Institute, Federal University of São Paulo, São Paulo, Brazil , Sergio Tomaz SchettiniSergio Tomaz Schettini Department of Pediatric Surgery, Pediatric Oncology Institute, Federal University of São Paulo, São Paulo, Brazil , Simone de Campos Vieira AbibSimone de Campos Vieira Abib Department of Pediatric Surgery, Pediatric Oncology Institute, Federal University of São Paulo, São Paulo, Brazil , José Honório Palma da FonsecaJosé Honório Palma da Fonseca Department of Cardiovascular Surgery, Pediatric Oncology Institute, Federal University of São Paulo, São Paulo, Brazil , Mônica CyprianoMônica Cypriano Department of Pediatric Oncology, Pediatric Oncology Institute, Federal University of São Paulo, São Paulo, Brazil , and Nasjla Saba da SilvaNasjla Saba da Silva Department of Pediatric Oncology, Pediatric Oncology Institute, Federal University of São Paulo, São Paulo, Brazil View All Author Informationhttps://doi.org/10.1016/S0022-5347(06)00561-1AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Vascular extension to the vena cava occurs in 4% of Wilms tumor cases and can reach the right atrium in up to 1%. When this happens the thrombus is usually not adherent to the vessel wall, and there is blood flow around it. Preoperative chemotherapy can cause thrombus regression and even resolution. If the thrombus persists after chemotherapy, surgery will be a challenge. On the other hand, if the thrombus invades the vessel wall, its removal may not be feasible. In this situation cavectomy is a good surgical strategy because it provides complete resection. The prerequisite for cavectomy is the absence of blood flow in the vena cava on preoperative Doppler ultrasonography. We report 3 cases of Wilms tumor with vena caval invasion in which cavectomy was performed, and discuss the principles, indications and operative technique. Materials and Methods: A total of 171 patients with Wilms tumor were treated at our institution between 1984 and 2004. Of these patients 6 with intravascular extension of thrombus within the right atrium were treated with extracorporeal circulation, cardiac arrest and profound hypothermia, and 3 were treated with cavectomy. Results: There were no instances of surgical complications or postoperative renal failure in our patients who underwent cavectomy. All remain well and free of disease. Conclusions: Cavectomy is a safe procedure for treating pediatric patients with Wilms tumor when there is extension and invasion of the vena cava wall without blood flow. References 1 : Intracaval and atrial involvement with nephroblastoma: review of National Wilms Tumor Study-3. J Urol1988; 140: 1113. Link, Google Scholar 2 : Intravascular extension of Wilms tumor. Ann Surg2001; 234: 116. Google Scholar 3 : Surgery of cavoatrial tumor thrombus in nephroblastoma: a report of the SIOP/GPOH Study. Pediatr Blood Cancer2004; 43: 40. 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Google Scholar © 2006 by American Urological AssociationFiguresReferencesRelatedDetails Volume 176Issue 1July 2006Page: 279-284 Advertisement Copyright & Permissions© 2006 by American Urological AssociationKeywordsinferiorvenous thrombosiskidney neoplasmsWilms tumorvena cavaMetricsAuthor Information Rodrigo Chaves Ribeiro Department of Pediatric Surgery, Pediatric Oncology Institute, Federal University of São Paulo, São Paulo, Brazil More articles by this author Sergio Tomaz Schettini Department of Pediatric Surgery, Pediatric Oncology Institute, Federal University of São Paulo, São Paulo, Brazil More articles by this author Simone de Campos Vieira Abib Department of Pediatric Surgery, Pediatric Oncology Institute, Federal University of São Paulo, São Paulo, Brazil More articles by this author José Honório Palma da Fonseca Department of Cardiovascular Surgery, Pediatric Oncology Institute, Federal University of São Paulo, São Paulo, Brazil More articles by this author Mônica Cypriano Department of Pediatric Oncology, Pediatric Oncology Institute, Federal University of São Paulo, São Paulo, Brazil More articles by this author Nasjla Saba da Silva Department of Pediatric Oncology, Pediatric Oncology Institute, Federal University of São Paulo, São Paulo, Brazil More articles by this author Expand All Advertisement PDF downloadLoading ...
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