Boiko S. Surgical Principles of Treatment and Prevention of Pulmonary Embolism in Implantation Venous Thrombi of Left Kidney Tumors

Based on the results of the research, information was obtained about new data on the clinical anatomy of the inferior vena cava, and the priority and stages of manipulations in the surgical treatment of left kidney cancer with implantation venous thrombus and measures to prevent pulmonary embolism were introduced. For the first time, the frequency of retrograde spread of tumor thrombus in left kidney cancer with implantation thrombus was established. The ways of venous return to the heart in conditions of occlusive tumor thrombus of the left renal vein and inferior vena cava have been established. Indications for mechanical hardware cavaplication in left kidney cancer with implantation venous thrombus were determined for the first time and its effectiveness in the prevention of pulmonary embolism was proven. For the first time, the indications for extended para-aortic lymphodissection in left kidney cancer with implantation venous thrombus have been substantiated. For the first time, it was established that after thrombectomy, the linear velocity of blood flow becomes uniform in the infrarenal and suprarenal segments of the inferior vena cava, and the applied cavaplication does not affect the deterioration of these parameters. Adverse prognostic criteria for survival of patients with left kidney cancer with implantation tumor thrombus were established. Keywords: left kidney, cancer, inferior vena cava, thrombosis, ischemia, surgical treatment, revascularization, cavaplication, pulmonary embolism.