The experience of surgical treatment of leiomyosarcoma of the inferior vena cava and its tributaries

Abstract

The report is about 4 clinical observations that demonstrate advanced capabilities of surgical treatment of leiomyosarcoma of the inferior vena cava and its main tributaries (gonadal, common iliac, and renal veins). The clinical examples present variants of vascular reconstructions in stages, namely, alloprosthesis of the infrarenal segment of the inferior vena cava and the bifurcated aortoiliac alloprosthetics. The article also considers the technique of «kidney-preserving» operations for the leiomyosarcoma of the left renal vein: tumornephrectomy without ureter intersection using the reversible pharmaco-cold ischemia, extracorporeal resection of the renal vein with a tumor and the kidney orthotopic replantation with alloprosthetics of the left renal vein. The article includes features of the postoperative period, the immediate and long-term results of specialized antineoplastic treatment.