Simultaneous surgical treatment of hepatocellular carcinoma with tumor thrombus in the inferior vena cava and ischemic heart disease – own research and literature review-Reference-Cited by-同舟云学术

Simultaneous surgical treatment of hepatocellular carcinoma with tumor thrombus in the inferior vena cava and ischemic heart disease – own research and literature review

Published:2022-02-11 Issue:4 Volume:94 Page:1-6
ISSN:0032-373X
Container-title:Polish Journal of Surgery
language:
Short-container-title:Pol Przegl Chir

Author:

Mech Katarzyna¹,Lisowska Joanna¹,Guzel Tomasz¹,Czub Paweł²,Żbikowska Karolina²,Rosiak Grzegorz³,Śmigielska Kaja⁴,Madej Krzysztof⁵,Nyckowski Paweł⁴,Słodkowski Maciej⁴,Hendzel Piotr²

Affiliation:

1. Department of General, Gastroenterology and Oncologic Surgery, University Clinical Center of the Medical University of Warsaw, Poland

2. Department of Cardiovascular Surgery, University Clinical Center of the Medical University of Warsaw, Poland

3. Department of Clinical Radiology, University Clinical Center of the Medical University of Warsaw, Poland

4. Department of General, Gastroenterology and Oncologic Surgery, University Clinical Center of the Medical University of Warsaw

5. Department of General, Vascular and Transplant Surgery, University Clinical Center of the Medical University of Warsaw, Poland

Abstract

Introduction: Hepatocellular carcinoma (HCC) is the third leading cause of cancer-related death worldwide. Tumor penetration into the inferior vena cava/right atrium is rare, as it occurs only in 3–4% of HCC patients. There are no clear guidelines for the management of this stage of disease. Aim: This is a case report of a patient with HCC and tumor thrombus in the inferior vena cava and with advanced coronary artery disease. Materials and methods: The patient was qualified for a simultaneous cardiac surgery and liver resection with removal of the tumor thrombus from the inferior vena cava due to a high risk of sudden cardiac death. The first stage involved aortocoronary bypass followed by a right-sided hemihepatectomy with removal of the tumor thrombus from the inferior vena cava (this part of the operation was performed by extracorporeal circulation). The postoperative period was uneventful. Surgical treatment is one of the therapeutic options that offers a chance to radically remove the tumor and extend the patient's life. From a standpoint, these operations are extremely difficult and carry a high risk of perioperative complications (up to 40%). At the same time, the patient is at risk of complications due to cancer, such as pulmonary embolism, tricuspid stenosis, and congestive heart failure, which should be considered when choosing a treatment method. A significant number of patients also suffer from chronic conditions that worsen the prognosis. Cardiac diseases combined with tumor thrombus in the inferior vena cava may cause sudden cardiac death. Conclusions: Surgical treatment should be considered in patients with HCC and tumor thrombus in the inferior vena cava, especially in patients with cardiovascular disease burden, as it is not only a chance to prolong life, but also to protect them against life-threatening cardiac complications.

Publisher

Index Copernicus

Subject

General Medicine,Surgery

Link

https://ppch.pl/gicid/pdf/01.3001.0015.7358

Reference26 articles.

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