累及下腔静脉的腹膜后肿瘤的外科处理(附14例报告)  

Surgical treatment of retroperitoneal tumor invading the inferior vena cava: a report of 14 cases

作　　者：丁家增[1] 彭承宏[1] 匡洁[1] 金筱泰[1] 严佶祺[1] 李勤裕[1] 杨卫平[1] 李宏为[1] 

机构地区：[1]上海交通大学医学院附属瑞金医院外科,上海200025

出　　处：《外科理论与实践》2008年第3期210-212,共3页Journal of Surgery Concepts & Practice

摘　　要：目的:探讨累及下腔静脉的腹膜后肿瘤切除时,联合下腔静脉切除和重建的处理方法。方法:回顾分析2003年1月至2007年10月收治的14例累及下腔静脉的腹膜后肿瘤的手术切除及下腔静脉重建的临床资料。结果:所有病人均成功实施肿瘤的完整切除,腔静脉的重建方法包括:下腔静脉侧壁部分切除,单纯修补7例;部分腔静脉切除(<2cm)端端吻合4例;部分腔静脉切除,人工血管重建3例。本组无手术死亡。随访12例,平均生存时间(38.6±5.8)个月。结论:术前B超、CT、MRI及血管造影等影像学检查至关重要。下腔静脉受累并非手术的禁忌。为减少腹膜后肿瘤术后复发和提高生存率,联合下腔静脉切除和重建是安全、有效和可行的。Objective To discuss the resection and reconstruction of the inferior vena cava （IVC） invaded by retroperitoneal tumor. Methods The clinical data from 14 patients with retroperitoneal tumor undergoing concomitant resection and reconstruction of the IVC were analyzed retrospectively. Results The retroperitoneal tumor was resected completely in all cases. Concomitant treatment of the IVC invaded by the tumor： （1） partial resection of the lateral wall of the IVC followed by local repair, 7 cases; （2） segmental resection of the IVC （〈2 cm in length） followed by end-to-end anastomosis, 4 cases; （3） segmental resection of the IVC followed by insertion of a prosthetic graft, 3 cases. There was no mortality in the series. Twelve cases were followed-up, with an average survival time of （38.6±5.8） months. Conclusions Invasion of the IVC by a retroperitoneal tumor does not constitute a contra-indlcation to its surgical treatment. In order to avoid recurrence and to ameliorate prognosis, concomitant resection of the IVC is a safe, effective and feasible procedure.

关 键 词：腹膜后肿瘤 腔静脉 下 血管外科手术 

分 类 号：R735.4[医药卫生—肿瘤]