Blood in urine, examination revealed kidney tumor with bud spreading close to the heart

About 3 weeks ago, Mr. P. had symptoms of fresh blood in the urine with blood clots. He went to the doctor and the doctor discovered a tumor in his left kidney.

At Binh Dan Hospital, through MSCT scan, doctors discovered that he had a left kidney tumor measuring 68x49 mm that had invaded the surrounding fatty tissue. This tumor had a bud that spread into the vena cava, approaching the right atrium. Surgery was the only way to save the patient's life before the bud invaded the heart or embolized the pulmonary artery.

High risk of death

Dr. Ho Khanh Duc, Head of the Cardiovascular Surgery Department at Binh Dan Hospital, said that this was a very difficult surgical case, requiring the smooth coordination of doctors from many specialties including urology, vascular, cardiovascular, hepatobiliary, internal medicine and the anesthesia and resuscitation team. This surgical process also requires the support of an extracorporeal circulation system to control and isolate the heart, preventing blood from flowing to the vein being operated on so that doctors can operate accurately.

"If not operated on promptly, the patient is at risk of death within a few days when the tumor causes blockage of blood flow to the heart or pulmonary embolism on the basis of diabetes and coronary atherosclerosis," Dr. Duc shared.

Doctors during surgery on a patient

The surgery took about 6 hours, the total time of extracorporeal circulation was 60 minutes. The time to open the atrium and vena cava to remove the tumor was about 20 minutes. After the surgery, the doctors ensured the patient's hemodynamics, removed the entire tumor, ensuring the treatment principles of kidney cancer, not allowing the tumor to travel to the heart and block the pulmonary artery. At the same time, the patient did not lose a large amount of blood.

"This was a difficult surgery, with complex underlying pathologies and a 90% mortality risk. With the determination of the hospital's leadership, the good coordination of many specialties of cardiology, urology, and the important role of anesthesia and resuscitation, the surgery was successful. On the first postoperative day, the patient had the endotracheal tube removed, could breathe on his own, and all vital signs were stable. The patient was discharged on the 7th postoperative day," shared Dr. Ho Khanh Duc.

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