Abstract
We have treated 5 patients with inferior vena caval obstruction caused by invasion of malignant tumor over past 17years. They comprised 1 man and 4 women aged from 55 to 75 years (mean: 68 years). The causes of obstruction were spread of renal cell carcinoma to the inferior vena cava (IVC) in 4 patients and metastasis of breast cancer to the IVC in 1 patient. Obstruction was between the renal vein inflow and hepatic vein inflow in 3 patients, at the site of hepatic vein inflow in I patient. between the renal vein inflow and the right atrium in 1 patient. The operations were nephrectomy combined with tumor thrombectomy in 4 patients and IVC-right atrial bypass in 1 patient.
There were no postoperative complications and all the patients were discharged from hospital. However, the graft became occluded or the IVC became obstructed again from 1 month to 3 months postoperatively in 2 of 5 patients. Three of 5 patients died of cancer at 6~13 months postoperatively, while the others 2 patients have survived for 3 year and 5 months to 4 year and 3 months, respectively.
Obstruction of the IVC by malignancy should be treated surgically if there is no distant or lymphnode metastasis.
