First laparoscopic surgery to save kidney cancer patient with tumor buds

On June 25, 2023, Associate Professor, Dr. Thai Minh Sam, Head of the Department of Urology, Cho Ray Hospital, said that the hospital had just successfully treated a patient with kidney cancer with a tumor in the vena cava using the classic laparoscopic surgery method. This is considered the first case in Vietnam with the above pathology to be treated with this method.

Previously, at the end of March, a male patient (54 years old, living in Ho Chi Minh City) with many underlying diseases including high blood pressure, diabetes, and hepatitis B came to Cho Ray Hospital for examination because of symptoms of anorexia and weight loss lasting 2 months.

Through CT scan, doctors discovered that the patient had a 7cm tumor in the right kidney, with a tumor bud entering the renal vein and vena cava. After consultation, the treatment team advised the patient and relatives about the indication for surgery to remove the entire kidney containing the tumor and remove the entire tumor bud in the vein by laparoscopic surgery.

After more than 5 hours of surgery, the patient underwent laparoscopic surgery to remove the entire kidney containing the tumor and open the inferior vena cava to remove the bud with the time to control the vena cava (the largest vein in the body) being 25 minutes. The surgery went smoothly and there were no complications during or after surgery.

The patient's postoperative recovery was also quick, with little pain, early return to normal movement, and he was discharged on the 5th day after surgery. At follow-up visits after 1 month and 3 months, the patient's condition was completely stable.

Lần đầu tiên phẫu thuật nội soi cứu bệnh nhân ung thư thận có chồi bướu - Ảnh 1. — The team during endoscopic surgery for the patient

According to Associate Professor, Dr. Thai Minh Sam, kidney cancer is a common type of urinary tract cancer, accounting for 2-3% of all cancers. According to the natural progression of the disease, kidney cancer can develop into tumors in the veins.

"Without treatment, the average survival time of a patient is 5 months and when the patient undergoes surgery to remove the kidney and the tumor in the vein, the average 5-year survival rate is 64% (46-82%) according to reports from medical literature. In medical literature, 4-10% of cases of tumor are located in the inferior vena cava and less commonly, 1% can spread to the right atrium," said Associate Professor Sam.

To date, Cho Ray Hospital has performed more than 50 surgeries for kidney tumors with tumor buds in the vein. However, all of the above cases were performed by open surgery to remove the buds. And the case of the above patient is the first case in Vietnam to have kidney surgery and tumor buds removed in the vena cava by conventional laparoscopic surgery.

Dr. Chau Quy Thuan, Deputy Head of the Department of Urology, said that radical nephrectomy and vena cava resection to treat kidney cancer has long been one of the most complicated surgeries in urology, in which open surgery is considered the standard approach.

"As a tertiary hospital, we have encountered many cases of kidney tumors with buds and have a lot of experience in treating these cases. However, this is the first time a patient has had surgery to remove a vein tumor completely through laparoscopy. This is a complicated surgery that requires high technique and expertise from the surgical team," Dr. Thuan shared.

Laparoscopic surgery has the advantage of being minimally invasive, helping patients recover quickly after surgery. The cost is equivalent to other conventional laparoscopic surgeries and is covered by health insurance.

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