Application of Intraoperative Transesophageal Echocardiography in the Treatment of Renal Cell Carcinoma with Inferior Vena Cava Tumor Thrombus.
10.3881/j.issn.1000-503X.15060
- Author:
Jiang-Hua JIA
1
;
Xu-Ze LI
2
;
Feng WANG
3
;
Ming ZHANG
1
;
Qing-Song MENG
1
;
Zi-Yue MA
1
;
Xin WANG
1
Author Information
1. Department of Urology, the Second Hospital of Hebei Medical University,Shijiazhuang 050031,China.
2. Department of Anesthesiology, the Second Hospital of Hebei Medical University,Shijiazhuang 050031,China.
3. Department of Cardiac Ultrasound, the Second Hospital of Hebei Medical University,Shijiazhuang 050031,China.
- Publication Type:Journal Article
- Keywords:
floating tumor thrombus;
renal cell carcinoma;
transesophageal echocardiography;
tumor thrombectomy;
venous tumor thrombus
- MeSH:
Humans;
Carcinoma, Renal Cell/surgery*;
Echocardiography, Transesophageal;
Vena Cava, Inferior;
Echocardiography;
Kidney Neoplasms/surgery*
- From:
Acta Academiae Medicinae Sinicae
2023;45(1):28-32
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the value of intraoperative transesophageal echocardiography (TEE) in the diagnosis and treatment of renal cell carcinoma with inferior vena cava tumor thrombus. Methods Ten patients of renal cell carcinoma with inferior vena cava tumor thrombus treated in the Second Hospital of Hebei Medical University from January 2017 to January 2021 were selected.TEE was employed to locate the position of the tumor thrombus,determine the occlusion point of the inferior vena cava,count the intraoperative tumor thrombus shedding rate,examine the tumor thrombus resection integrity,and measure blood loss and other indicators,on the basis of which the application value of TEE in the operation of renal cell carcinoma with inferior vena cava tumor thrombus was evaluated. Results All the 10 patients had completed the operations successfully,including 8 patients of open operation and 2 patients of laparoscopic operation.TEE showed tumor thrombi clearly,and all the tumor thrombi were completely removed.There was no tumor thrombus shedding during the operation.The blood loss varied within the range of 300-800 ml,with the mean of (520.0±193.2) ml.The grade III tumor thrombi in 2 patients and the grade I tumor thrombus in 1 patient diagnosed before operation were reduced to grade Ⅱ and upgraded to grade Ⅱ,respectively,by TEE.One patient had no floating tumor thrombus at the end of tumor thrombus before operation,and the blocking position was adjusted in time with the assistance of TEE to avoid the shedding of the floating tumor thrombus. Conclusion TEE can accurately determine and dynamically monitor the location and shape of inferior vena cava tumor thrombus,which provides an important reference and has a significant clinical value in the operation of renal cell carcinoma with inferior vena cava tumor thrombus.
