摘要
目的腹膜后肿瘤累及下腔静脉时,评估单纯结扎和切除下腔静脉的可行性和安全性。方法2007年12月至2008年12月收治的腹膜后肿瘤病人116例,接受手术的93例完全切除率93.55%,肿瘤累及下腔静脉共13例(11.2%),按照肿瘤累及位置将下腔静脉分为3个节段,A:第二肝门至肾静脉以上;B:肾静脉节段下腔静脉;C:肾静脉以下至髂血管分叉。结果A组2例,B组2例,C组8例,1例累及下腔静脉全程。下腔静脉修补5例,肾静脉以下至髂血管分叉下腔静脉单纯切除、远近端缝扎4例,肾静脉平面节段下腔静脉切除,两侧肾静脉结扎1例,第二肝门至肾静脉以上平面结扎2例,下腔静脉全程切除1例。结论腹膜后肿瘤累及并导致下腔静脉闭塞时,第二肝门至肾静脉以上平面下腔静脉结扎并不影响肾脏和其他盆腔器官的血液回流,切除累及肾静脉平面下腔静脉时,肾功能可能受损。肾静脉以下至髂总静脉分叉平面受累的下腔静脉无论是否闭塞,均可安全结扎或切除。
Objective To assess the feasibility and safety of excising or patching the inferior vena cava （IVC） without replacement in patients with primary retroperitoneal tumors （PRPT） involving the IVC. Methods A retrospective analysis was conducted in 116 consecutive patients with PRPT presented to our Hospital between December 2007 and December 2008. IVC involvement was found in 11.2% of the cases, and in 93 cases receiving surgical tumor removal, the complete resection rate was 93.55%. According to the location oflVC involvement by the PRPT, the cases were classified into 3 groups with IVC involvement in the segment fi＇om the second hepatic portal vein to the renal vein （segment A）, the segment on the bilateral renal vein plane （segment B）, and the segment from the caval bifurcation to the renal vein （segment C）. Results The most common vascular involvement occurred in segment C （61.54%, 8/13）, and 2 cases presented with segment A involvement and 2 had segment B involvement. All the 3 segments oflVC were involved in 1 case. Five cases with IVC involvement received IVC patching only, and 4 had resection or ligation of the segment C of the 1VC, and resection of the segment A and B of the IVC was performed in 2 and 1 case, respectively. One patient received complete resection of whole IVC involved. All patients recovered smoothly and were discharged. Conclusions The inffarenal 1VC can be ligated or resected safely without reconstruction. Combined resection of the bilateral renal vein and segment B of the IVC may result in renal insufficiency. IVC involvement and occlusion between the second hepatic portal and renal veins can be ligated safely without affecting the renal function.
出处
《南方医科大学学报》
CAS
CSCD
北大核心
2009年第5期922-924,928,共4页
Journal of Southern Medical University
基金
国家自然科学基金(30872468)
关键词
腹膜后肿瘤
下腔静脉
结扎
下腔静脉切除
肿瘤/外科学
retroperitoneal neoplasms
inferior vena cava
ligation
inferior vena cava resection
tumor/surgery
