Tumour Thrombi in the Suprahepatic Inferior Vena Cava: The Cardiothoracic Surgeons’ View

Table 1

Intrathoracic Caval Tumour Thrombi, cumulative perioperative data from 29 series: Apart from the numbers of ICTT-III and ICTT-IV, values are average.

	Total	ICTT-III	ICTT-IV
N	784	453	331
Age	59	52	56
Gender
Male	62%	70%	53%
Female	38%	30%	43%
Primary Tumour Side
Right	64%	76%	54%
Left	36%	24%	46%
Histology
Renal Cell Carcinoma	98%	99%	98%
Wilms or, Adrenal	1%	1%	1%
Transitional L Cell Carcinomas	1%	0%	1%
Pre-embolisation strategies	29%	22%	30%
Echo studies	88.50%	83.50%	89%
Incision
Midline Laparotomy	11%	16%	2%
Midline Laparotomy; + Sternotomy	26%	20%	38%
Thoracoabdominal	3%	4%	6%
Chevron	34%	51%	8%
Chevron + Sternotomy	27%	9%	46%
IVC Resection and graft	12%	5%	19%
IVC clamps
Partial	22%	22%	21%
Complete	57%	71%	32%
Piggy-back' Liver	62%	72%	40%
Pringle Manoeuver	59%	60%	40%
Perfusion Strategies
None	51%	84%	12%
Cardiopulmonary Bypass; without Arrest	44%	10%	84%
Circulatory Arrest	35%	10%	59%
Venous bypass	5%	6%	4%
Cardiopulmonary Bypass times	103 min	88 min	106 min
Circulatory Arrest times	25 min	23 min	26 min
Procedure duration	358 min	339 min	378 min
Anaesthesia time	362 min	331 min	396 min
Estimated blood Loss	3190 mL	2665 mL	3724 mL
Volume of Transfusion	3142 mL	2404 mL	3548 mL
Mortality	10%	5%	15%
Morbidity	56%	36%	64%
Haemorrhage and reoperation	14%	9%	26%
Deep venous Thrombosis	2%	1%	1%
Pulmonary Embolism	3%	2%	5%
Myocardial Infarction	1%	3%	0
Dysrhythmias	2%	2%	2%
Abdominal complications	5%	10%	6%
Sepsis/Infectious complications	4%	4%	6%
Acute Renal Failure	4%	4%	6%
Any other complications	3%	4%	5%
Length of Hospital Stay	13	14	13