Anesthetic Management of Radical Nephrectomy with Inferior Vena Cava Tumor Thrombus: a Case Report
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Abstract
Renal cell carcinoma may extend into the venous system; a condition associated with increased surgical and anesthetic complexity. Tumor thrombus involving the renal vein or inferior vena cava (IVC) poses significant perioperative challenges, including major bleeding, abrupt changes in venous return, and potential tumor embolization. We report the case of a 56-year-old patient with a large renal tumor and tumor thrombus involving the renal vein and the inferior vena cava who underwent radical nephrectomy. Perioperative management included balanced general anesthesia combined with single-shot spinal analgesia, invasive hemodynamic monitoring, vasoactive support, and goal-directed transfusion therapy guided by laboratory parameters and clinical assessment. The procedure was completed without major complications, highlighting the importance of structured perioperative preparation in high-risk oncologic surgeries.
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