|Table of Contents|

Retrospective analysis of anesthesia management in patients with renal cell carcinoma complicated with tumor thrombus in inferior vena cava

Journal Of Modern Oncology[ISSN:1672-4992/CN:61-1415/R]

Issue:
2025 04
Page:
653-659
Research Field:
Publishing date:

Info

Title:
Retrospective analysis of anesthesia management in patients with renal cell carcinoma complicated with tumor thrombus in inferior vena cava
Author(s):
WANG Yi1; ZHU Zheng2; WANG Yonghui1; FU Jingwen1; ZHU Zhenghua1; LU Zhihong1; FAN Qianqian1
1.Department of Anesthesiology and Perioperative Medicine；2.Department of Urology，Xijing Hospital，Air Force Medical University，Shaanxi Xi'an 710032，China.
Keywords:
renal carcinoma; inferior vena cava; tumor thrombus; anesthesia
PACS:
R737.11
DOI:
10.3969/j.issn.1672-4992.2025.04.016
Abstract:
Objective:To summarize the key points of anesthesia management for patients who underwent nephrectomy with inferior vena cava thrombectomy,and compare the incidences of severe intraoperative adverse events between patients with Mayo grade Ⅰ-Ⅱ and grade Ⅲ-Ⅳ inferior vena cava tumor thrombus.Methods:A retrospective analysis was performed on the clinical data of patients who underwent nephrectomy with inferior vena cava thrombectomy in our hospital from January 2012 to March 2024.Patients' basic information,anesthesia management strategies,and the occurrence of intraoperative serious adverse events were recorded.Results:A total of 43 patients were included in this study,aged 41~81 years,with 9 cases of Mayo grade Ⅰ,27 cases of Mayo grade Ⅱ,6 cases of Mayo grade Ⅲ,and 1 case of Mayo grade Ⅳ for inferior vena cava tumor thrombus.The incidences of intraoperative adverse events were 30.2% for massive hemorrhage,32.6% for circulatory instability,11.6% for arrhythmia,9.3% for acute heart failure,4.7% for pulmonary embolism,and 2.3% for intraoperative cardiac arrest and respiratory arrest.Compared to patients with Mayo grade Ⅰ-Ⅱ,those with grade Ⅲ-Ⅳ had significantly increased intraoperative blood loss and a higher incidence of massive hemorrhage(P＜0.05).Compared with baseline values,the serum levels of creatinine,alanine aminotransferase,and aspartate aminotransferase on postoperative day 1 were significantly increased(P＜0.05).Conclusion:Patients undergoing nephrectomy with inferior vena cava thrombectomy have a high incidence of intraoperative massive hemorrhage and severe cardiovascular adverse events.The intraoperative blood loss and the incidence of massive hemorrhage significantly increase in Mayo grade Ⅲ-Ⅳ patients compared to those in Mayo grade Ⅰ-Ⅱ.It is essential for anesthesiologists to conduct a comprehensive preoperative assessment and preparation,understand the surgical process,and be proficient in identifying,diagnosing,and managing severe complications such as pulmonary embolism.At the same time,close attention should be paid to the protection of vital organ functions.

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