Surgical Management of Renal Cancer with IVC Thrombus — A Complex Case by Dr. Manoj Dongare
How a 35-Year-Old Patient with Advanced Kidney Cancer and IVC Thrombus Was Successfully Treated in Pune
Fear can sometimes be the biggest obstacle to timely medical treatment. This is the story of a young 35-year-old gentleman who delayed his kidney cancer surgery for three years — and how expert surgical intervention by Dr. Manoj Dongare ultimately saved his life despite the enormous complexity of the case.
The Patient and His Story
Three years before presenting to us, this 35-year-old male patient was already diagnosed with a left renal mass — a growth on his left kidney. Unfortunately, out of fear, he chose not to undergo surgery at that time.
Three years later, he developed severe pain in the left flank. When he finally came forward for treatment, investigations painted a much more serious picture than before.
CT scan findings revealed:
A huge renal cancer involving the left kidney
The tumour had extended into the left renal vein.
The cancer thrombus (blood clot containing cancer cells) had grown into the Inferior Vena Cava (IVC) — the largest vein in the body — just below the opening of the hepatic veins.
The mass was stuck to the psoas muscle and involved the left mesocolon.
The patient was referred to Dr. Manoj Dongare, a renowned surgical oncologist and best cancer specialist practising at D.Y. Patil Medical College, Hospital and Research Centre, Pimpri, Pune and Cloverleaf Speciality Clinic, Wakad, Pune-PCMC.
PET Scan Result: No evidence of distant metastasis — the disease was still localised, giving a chance for curative surgery.
Understanding the Complexity — What is IVC Thrombus in Renal Cancer?
When kidney cancer grows, it can sometimes extend into the renal vein and travel upward into the IVC — the major vein that carries blood from the lower body back to the heart. This is called an IVC thrombus.
The thrombus can break off and travel to the lungs, causing a life-threatening pulmonary embolism
Surgery becomes extremely complex as it involves the major blood vessels of the body
Multiple organs may need to be managed or removed simultaneously
This type of surgery requires not just a skilled cancer surgeon but a specialist with deep expertise in vascular and hepatobiliary surgery — exactly the kind of expertise Dr. Manoj Dongare brings to every case.
The Surgery — A Multi-Step, High-Precision Procedure
The surgical team, led by Dr. Manoj Dongare, performed one of the most technically demanding operations in surgical oncology. Here is a step-by-step account of what was done:
Exploration of the abdomen — The surgical team assessed the full extent of the tumour, confirming it was stuck to the psoas muscle and involved the left mesocolon
Mobilisation of the right lobe of the liver — To gain access to the IVC and the hepatic veins
Mobilisation of the caudate lobe off the IVC — A delicate step requiring precise dissection near the liver
Looping of the intrahepatic IVC and the IVC just below the hepatic veins — To control blood flow and safely open the vein
Looping of the left and right renal veins — To isolate the renal circulation
Tying of the adrenal and lumbar veins — To prevent bleeding during IVC opening
Opening of the IVC and delivery of the thrombus — The cancer thrombus was carefully extracted from inside the vein
Left nephrectomy — Complete removal of the cancerous left kidney
Colon resection with primary anastomosis — Since the tumour had involved the left colon, that portion of the colon had to be sacrificed, and the two ends rejoined in a single operation
Each of these steps carried significant risk, and the successful completion of all of them in a single surgery reflects the exceptional skill and preparation of Dr. Manoj Dongare and his team.
The post-operative period was closely monitored. The patient experienced ileus — a temporary paralysis of the bowel — which is a known complication after such extensive abdominal surgery involving the colon.
Day 1–7 — Patient managed with supportive care for post-operative ileus
Day 7 onwards — Bowel function gradually recovered
Discharged in stable condition after full recovery
Despite the complexity of the surgery and the post-operative challenge, the patient made a full recovery — a testament to both surgical expertise and dedicated post-operative care.
Why Choose Dr. Manoj Dongare for Complex Cancer Surgery?
Dr. Manoj Dongare is a highly experienced surgical oncologist and the best kidney cancer specialist with expertise in complex HPB, vascular, and cancer surgeries. He practises at D.Y. Patil Medical College, Hospital and Research Centre, Pimpri, Pune and Cloverleaf Speciality Clinic, Wakad, Pune-PCMC.
Renal cancer surgery with IVC thrombus
Complex liver, pancreas, and biliary surgeries
Multi-organ resections for advanced cancers
Minimally invasive and open surgical approaches
Comprehensive pre-operative planning and post-operative care
If you or a loved one has been diagnosed with kidney cancer, renal vein involvement, or IVC thrombus, do not wait. Early consultation with an expert can save your life.
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