A novel strategy for reconstruction of the renal vein and inferior vena cava (IVC) after resection of IVC leiomyosarcoma-a case report

Abstract

A 30-year-old male patient diagnosed leiomyosarcoma originating from level II of inferior vena cava (IVC). The tumor involved IVC, right renal vein, the confluence of left renal vein and IVC, and the dorsal part of pancreatic head. An enbloc resection was performed and multiviscera including involving IVC, right renal vein, the inferior wall of confluence of left renal vein and IVC, and pancreaticoduodenum were resected with tumor. To ensure the patency of the left renal vein and avoid serious vascular complications of vascular reconstruction after pancreaticoduodenectomy, a segment of distal IVC, as long as 2 cm, was excised to bridge right renal vein and the proximal end of IVC. The patient recovered smoothly after the operation. we named the strategy of vascular reconstruction as “sacrificing a rook to save the king.”