Table 1 Checklist for the Performance of Radical Nephrectomy and Tumor Thrombectomy
Preoperative Workup and Surgical Planning | ||||
|---|---|---|---|---|
History and physical exam performed | Yes | No | ||
Exam findings suggestive of a lack of collateral venous flow | Yes | No | ||
Medical consultations obtained and recommendations acted on | Yes | No | ||
Preoperative labs reviewed and abnormalities addressed | Yes | No | ||
MRI or CT scan within last 30 days | Yes | No | ||
Level of thrombus | I | II | III | IV |
Presence of bland thrombus on imaging | Yes | No | ||
Complete IVC obstruction on imaging | Yes | No | ||
Presence of venous collaterals on imaging | Yes | No | ||
Ancillary surgical teams consulted | Yes | No | ||
Need for an IVC filter to be placed preoperatively | Yes | No | ||
Informed consent obtained | Yes | No | ||
Anticoagulation therapy addressed | Yes | No | ||
Day of Surgery/Operating Room | ||||
Ancillary teams reminded | Yes | No | ||
ICU team notified | Yes | No | ||
Medications and allergies re-reviewed | Yes | No | ||
Previous anesthesia history reviewed | Yes | No | ||
Airway and aspiration risk evaluated | Yes | No | ||
Labs obtained day of surgery reviewed | Yes | No | ||
Surgical Site Marked | Yes | No | ||
Blood products available | Yes | No | ||
Cell saver available | Yes | No | ||
Display of appropriate imaging | Yes | No | ||
Anticipated equipment sterilized and in the room | Yes | No | ||
Introduction of all team members | Yes | No | ||
Confirm patient identity, procedure and site | Yes | No | ||
Delivery of antibiotic prophylaxis | Yes | No | ||
Arterial, peripheral, and central line placement | Yes | No | ||
TEE available | Yes | No | ||
Need for VVP and/or CPBP assessed and available | Yes | No | ||
Need for IVC resection assessed and graft material available | Yes | No | ||
Case Closure and Sign-out | ||||
Instrument, sharp, and towel counts correct | Yes | No | ||
Surgical specimens marked and identified | Yes | No | ||
Brief operative note completed | Yes | No | ||
Patient presented to ICU/recovery team notified | Yes | No | ||