Rare Surgical Procedure Saves Patient from Invasive Kidney Cancer

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**Doctors at University Medical Center Ho Chi Minh City Successfully Perform Surgery, Opening Up a Chance for Survival for a Complex Kidney Cancer Case**

On August 7, Dr. Doan Vuong Kiet, MD – Manager and Head of Operations of the Department of Functional Urology, University Medical Center Ho Chi Minh City, reported that a complex and rare surgery had just been successfully performed at his hospital.

The male patient, 73 years old, named H.M., residing in Ho Chi Minh City, suffered from severe invasive kidney cancer. This is the second such case performed at the hospital, marking an important step forward in treating complex cancer conditions.

Normally, in cases of kidney cancer with tumor thrombus invading the central vein like this, surgery is usually considered very carefully because it carries many significant risks, and most cases are treated with palliative care.

However, thanks to interdisciplinary coordination and thorough preparation, the team at University Medical Center Ho Chi Minh City completely removed the tumor, bringing hope for survival to the patient.

Patient H.M. was found to have a kidney tumor during a routine health check-up. CT scan results showed that the large tumor had invaded the perirenal fat layer and had a tumor thrombus invading the inferior vena cava, extending from the left renal vein to the hepatic vein, causing thrombosis throughout the entire inferior vena cava system, leading to blood stasis and pain in the left leg. The condition was particularly complex as the tumor thrombus had completely invaded the inferior vena cava – the pathway carrying blood from the lower body back to the heart.

According to Dr. Doan Vuong Kiet, Mr. M.'s condition was a major challenge. The surgery required removing the entire tumor mass and the tumor thrombus within the inferior vena cava. Therefore, the surgeons had to simultaneously control the risk of the tumor thrombus migrating to the heart and the risk of intraoperative bleeding. Both situations could be life-threatening for the patient on the operating table.

To solve this difficult problem, a multidisciplinary team was formed. Doctors from the Hepatobiliary specialty performed liver mobilization and exposure of the central vein.

Next, the Thoracic – Vascular specialty was responsible for controlling the central vein and removing the entire tumor thrombus and blood clot from the inferior vena cava. At the same time, the Functional Urology specialty removed the entire tumor mass and kidney. This stage required very rapid surgery to ensure the shortest possible time blocking blood flow to the heart and to minimize bleeding.

Throughout the process, the Cardiovascular Surgery and Anesthesiology – Resuscitation specialties had extracorporeal circulation techniques ready in case of need. The surgery lasted a tense 6 hours.

After the operation, the patient experienced one complication – bleeding from a small branch of the cut renal artery – but it was detected and handled promptly. Currently, the patient is stable and has been discharged from the hospital.

The surgery completely removed the cancerous tumor, improving the patient's survival prognosis. If not operated on in time, the tumor thrombus could have migrated to the heart at any moment, endangering the patient's life.

This is a rare case, with not many cases reported in world medical literature. The success of this surgery opens up new hope for many other patients with complex cancer conditions.
Link paper: https://www.phunuonline.com.vn/cuu-benh-nhan-ung-thu-than-xam-lan-bang-ca-phau-thuat-hiem-gap-a1556994.html