Evidence map›Paper›PMID 37621783›Full record

ArticleCureus2023

En-Bloc Resection of Renal Cell Carcinoma With Tumor Thrombus Propagating Into the Intrapericardial Inferior Vena Cava: Efficacy and Safety of Transabdominal Approach.

Theodoros Sidiropoulos, Stavros Parasyris, Vassiliki Ntella, Ioannis Margaris, Spyridon Christodoulou, Kassiani Theodoraki, Panteleimon Vassiliu, Vassilios Smyrniotis, Nikolaos Arkadopoulos

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In one paragraph

Article in Cureus, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.5field-weighted citation impact, top 29% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 2 citations in OpenAlex.

  1. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 1 institution in 1 country.

Theodoros Sidiropoulos4th Department of Surgery, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, GRC.
Stavros Parasyris4th Department of Surgery, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, GRC.
Vassiliki Ntella4th Department of Surgery, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, GRC.
Ioannis Margaris4th Department of Surgery, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, GRC.
Spyridon Christodoulou4th Department of Surgery, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, GRC.
Kassiani Theodoraki1st Department of Anesthesiology, Aretaieion University Hospital, National and Kapodistrian University of Athens, Athens, GRC.
Panteleimon Vassiliu4th Department of Surgery, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, GRC.
Vassilios Smyrniotis4th Department of Surgery, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, GRC.
Nikolaos Arkadopoulos4th Department of Surgery, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, GRC.
National and Kapodistrian University of Athens · GR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundRenal cell carcinoma (RCC) is the most common primary kidney cancer. In up to 4-10% of patients, the tumor is complicated with a malignant thrombus extending to the inferior vena cava (IVC). Complete surgical excision of the RCC and the neoplastic thrombus can be curative. We aim to present a safe and feasible alternative transabdominal operative technique with the omission of thoracotomy, as applied in six patients diagnosed with RCC and IVC thrombus extending over the diaphragm.

methodsThis case series study was conducted in a tertiary university hospital in Athens, Greece. All six patients, who were operated on for RCC and a malignant thrombus exceeding in the intrapericardial IVC in our department from January 2009 until March 2020, were screened. Intraoperatively, the infrarenal and intrapericardial IVC were clamped simultaneously with the renal and liver blood inflow. Access to the intrapericardial IVC was obtained via the central tendon of the diaphragm. Intrathoracic extension of the tumor was confirmed by transesophageal or intraoperative ultrasonography. The intrathoracic IVC was exposed to direct vision and two finger palpation was applied to secure the clamping of the IVC above the tip of the thrombus. The tumor was resected through a longitudinal venotomy and the operation was completed on a standard radical nephrectomy.

resultsDuring the study period six patients presented with RCC and intrapericardial IVC thrombus. All patients, five female and one male, underwent radical nephrectomy combined with IVC thrombectomy, without the need for a thoracotomy. The mean age was 66 years old and the mean operative time was 122.5 minutes. Mean blood loss was 338 ml and only four of the patients were transfused with two units of RBC. Operative and hospital mortality was 0%. The hospital stay was seven (six to nine) days. Only one patient required readmission and reoperation 30 days later, due to intrapericardial herniation.

conclusionsThe proposed surgical technique may be curative in patients with advanced intracaval thrombus and helps reduce the associated morbidity, mortality, and the overall cost of more extended operations.

Indexed as

neoplasmatic thrombus in intrapericardial ivcradical nephrectomy with ivc thrombectomyrcc with tumor thrombus in ivcrenal cell carcinomatransabdominal approach

Identifiers

PMID37621783
PMCPMC10446507
OpenAlexW4385191586

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.