How is a thrombus treated prior to performing a radical nephrectomy?

Updated: Feb 05, 2019
  • Author: Richard A Santucci, MD, FACS; Chief Editor: Bradley Fields Schwartz, DO, FACS  more...
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  • If a thrombus is present, preoperative embolization of the kidney often shrinks the thrombus, facilitating intraoperative removal. However, not all the centers embolize the kidney to shrink the thrombus. Perform embolization the day before or the same day of the surgery so that postembolization renal inflammation does not complicate the nephrectomy. Embolization may also be performed in some patients who are not fit enough for surgery and who have extensive bleeding. Recently, Subramanian et al (2009) reported on their 17-year experience with embolization. Of the patients in the report, 135 underwent embolization and 95 underwent surgery without embolization. They concluded that embolization does not provide any measurable benefit in reducing blood loss. Moreover, it was associated with increased major perioperative complications and mortality. [7]

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