Three common bleeding sites in complex large kidney cancer surgery

Clinically, renal cancer with a diameter greater than 7 cm, accompanied by lymph node metastasis, invasion of surrounding organs, and vena cava cancer thrombosis is called complex large renal cancer. This type of cancer is usually more difficult to perform surgery, and the incidence of accidental massive bleeding in the inferior vena cava and its branches during surgery is high.

It is generally believed that vena cava bleeding is caused by the tearing or avulsion of fragile branches of the inferior vena cava in predictable positions. The sites prone to massive bleeding mainly include the lumbar veins, right adrenal veins, and gonadal veins.

1. Lumbar veins: At each lumbar level, the lumbar veins merge into the vena cava at the side and rear. If the vena cava is pulled carelessly, the confluence of the lumbar veins may be torn off, causing bleeding. When separating the renal veins, if the lumbar veins may be hidden behind them without considering that there may be lumbar veins, severe bleeding may occur.

2. Right adrenal vein: The right adrenal vein flows into the inferior vena cava. The vein is fragile and thick, and is located high. Improper operation during separation may cause tearing and bleeding.

3. Gonadal vein: The gonadal vein joins the vena cava at the anterior and lateral position. If the vena cava is pulled too much near its confluence, it is easy to cause tearing and bleeding.

When kidney tumors gradually grow larger and develop into complex large renal cancer, not only does the treatment become more difficult, but it also brings great pain to the patient. Even with effective treatment, it is difficult to achieve a good prognosis. Therefore, early detection and early treatment should be carried out to control the progression of the disease in a timely manner.