Surgical treatment of renal adenocarcinoma with neoplastic thrombosis of the inferior vena cava

Personal experience in the surgical management of 15 cases of renal adenocarcinoma with neoplastic thrombosis of the vena cava inferior is described, and an account is given of the procedures adopted in accordance with the degree of endocavitary extension of the tumour. Emphasis is also placed on the need to ensure, as in all cases of nephrectomy for tumours, "neoplastic asepsis" by means of a preliminary vascular stage with the compartment intact. For this purpose, it is felt that sufficient preoperative angiographic evaluation of the intracavitary tumour is essential, coupled with absolute intraoperative control of the vena cava and/or right atrium proximally to the thrombus, to prevent the intraoperative mobilisation of neoplastic embolisms.