vena cava

Awareness of the variation and renal vascular abnormality at retroperitoneal space surgeries such as kidney surgery and transplantation is very important and necessary. Complexity in the veins development of the kidney area of fetus leads to a series of changes in the production of these veins, including the extra kidney vein, and the posterior aorta vein. In this case report, we present a case report of a 36-year-old male with a rare renal variation which has been identified with a simple abdominal Computed Tomography (CT) scan (16-slice). In this case report, there is a single renal vein which becomes two branches before drainage into Inferior Vena Cava (IVC) in which one of these branches passes anterior to aorta and the other posterior to aorta which suggests the type of circumaortic left renal vein.

Introduction: Inferior vena cava tumor thrombectomy in renal cell carcinoma patients is a challenging procedure, frequently requiring the vascular bypass technique for high-level thrombi with additional complications. Adopting a technique such as in-trapericardial control in selected cases will circumvent these problems. Here, we present the results of our intrapericardial control technique during supradiaphragmatic inferior vena caval tumor thrombectomy. Case Presentation: The records of six patients with supradiaphragmatic tumor thrombi, who underwent radical nephrectomy and thrombectomy at our center with intrapericardial control between the years 2008 and 2015, were retrospectively reviewed. The patients' characteristics, intra-and postoperative data, histology, and follow-up records were gathered and compared. There were no immediate or 30-day postoperative deaths. The mean age of the patients was 61.3 years (range 46-75). The total mean duration of surgery was 315 minutes and the mean amount of transfused red blood cells was 4.33 units during surgery and 0.8 units in the postoperative period. The average hospitalization duration was 8 days (range 5-17). Tumor stage was T3 in four patients and T4 in two, due to ipsilateral adrenal involvement. The mean duration of follow-up was 33.5 months. Only one of the patients developed recurrences, first in the tumor bed and then at the site of the skin incision; these were excised with no apparent complications. Conclusions: Radical nephrectomy and tumor thrombectomy by intrapericardial control without cardiopulmonary bypass and hypothermic circulatory arrest is a safe and effective procedure that can avoid serious intra-and postoperative complications while providing acceptable cancer-control and mortality results.