Temporary Balloon Occlusion of Inferior Vena Cava in Resection of Renal Tumor With Vena Cava Thrombus Extension

ObjectivesTo investigate a novel and effective method to occlude the inferior vena cava (IVC) during surgical management of a renal tumor with a tumor thrombus extension into the IVC.MethodsWe retrospectively reviewed the records of 10 patients with renal cell carcinoma or renal angiomyolipoma with tumor thrombus extending into the IVC who had undergone surgical intervention at our institute from May 2005 to May 2006. The balloon occlusion of the IVC was performed during surgery to decrease the risk of pulmonary embolism.ResultsOne patient could not tolerate the test occlusion of the IVC and the procedure was converted to IVC-right atrium bypass. The remaining 9 patients successfully underwent nephrectomy and thrombectomy with the help of temporary balloon obstruction of the IVC without perioperative mortality or morbidity. The blood pressure and circulatory status were stably maintained during occlusion of the IVC.ConclusionsTemporary balloon occlusion of the IVC is a simple and reliable technique that decreases the risk of pulmonary embolism and facilitates the resection of renal tumor with levels II and III IVC thrombus.