肾癌合并Ⅱ、Ⅲ型下腔静脉瘤栓11例手术疗效分析  

Effect of operation for kidney cancer with Ⅱ,Ⅲ type cancer embolus in the inferior vena cava

作　　者：赵玉洲[1] 韩广森[1] 袁启东 鲁朝敏[1] 谢建国[1] 顾焱晖[1] 袁龙[1] 

机构地区：[1]河南省肿瘤医院普外科,郑州450003 [2]河南省第三人民医院

出　　处：《现代泌尿生殖肿瘤杂志》2012年第2期69-71,共3页Journal of Contemporary Urologic and Reproductive Oncology

摘　　要：目的探讨经皮球囊导管阻断在合并Ⅱ、Ⅲ型下腔静脉瘤栓的肾癌患者的手术疗效。方法回顾性分析河南省肿瘤医院普外科自2006年7月至2011年3月治疗的11例合并Ⅱ、Ⅲ型下腔静脉瘤栓的肾癌患者的临床病理资料、手术方法及疗效。结果 11例患者的平均年龄为48.4岁(36～66岁),所有患者均经术前CT、MRI或彩超明确肿瘤及瘤栓情况。所有患者术前在DSA下经颈内静脉预置球囊导管在瘤栓附近,术中充盈球囊阻断下腔静脉后再切除肾脏及瘤栓。手术时间为(67.3±12.3)min,手术出血量为(762.3±125.5)ml,术后住院时间为(12.6±1.8)d,无手术或围手术期死亡。术后1年生存率为81%,3年生存率为54%。结论经皮球囊导管阻断法在肾癌合并Ⅱ、Ⅲ型下腔静脉瘤栓手术中是安全有效的预防瘤栓脱落方法,具有一定的临床推广价值。Objective To investigate the effect of the percutaneous balloon catheter occlusion in the operation for kidney cancer with Ⅱ,Ⅲ type cancer embolus in the inferior vena cava.Methods The clinical data,surgical methods and outcomes of the 11 patients with renal neoplasm into the inferior vena cava who received operation in the general surgery department of Henan tumor hospital from July 2006 to March 2011,were retrospectively analyzed.Results The average age of the 11 patients was 48.4（36-66） years.All patients with the tumor and cancer embolus were identified by preoperative CT,MRI or ultrasound.And each patients had a preoperatively percutaneous implatation of balloon catheter into the IVC,near the tumor embolus,under the DSA monitoring.During the surgery,the balloon was filled via the catheter to occlude the IVC prior nephrectomy and tumor thrombectomy.The operation time was（67.3±12.3） min,blood loss was（762.3±125.5） ml and the length of stay after operation was（12.6±1.8） days.No operative or perioperative death occurred.The 1-year survival rate was 81%,3-year survival rate was 54%.Conclusions Percutaneous balloon catheter occlusion technique for the surgery of kidney neoplasm with Ⅱ,Ⅲ type of cancer embolus in inferior vena cava is a safe and effective method of preventing thrombosis shedding,which has clinical value for popularization to some extent.

关 键 词：肾肿瘤 瘤栓 下腔静脉 经皮球囊导管阻断技术 

分 类 号：R737.11[医药卫生—肿瘤]