肝癌累及肝后下腔静脉的外科处理  

Surgical management of hepatic cancer involving retrohepatic inferior vena cava

作　　者：陈亚诺 徐庆祥 Chen Yanuo;Xu Qingxiang(Southeast University Medical School,Nanjing 210009,China)

机构地区：[1]东南大学医学院,南京210009

出　　处：《中华肝胆外科杂志》2023年第10期792-797,共6页Chinese Journal of Hepatobiliary Surgery

摘　　要：肝后下腔静脉(RIVC)起始于肾静脉根部,终于右心房。左、中、右肝静脉、肝右后下静脉等汇入其中。RIVC大部包裹于肝尾状叶,紧邻腹腔干、脊柱椎体,具有重要的解剖学意义。RIVC癌栓包括腔静脉内癌栓形成和肿瘤直接侵犯腔静脉壁两种,对应不同的外科处理方式。腔静脉内的癌栓可以通过取栓进行处理,而肿瘤侵犯腔静脉壁则需要切除受侵血管壁并进行血管重建,无论何种类型,外科处理不当均易造成损伤出血,后果严重。本文介绍了不同类型RIVC癌栓的外科处理要点,为RIVC癌栓的处理提供参考。Retrohepatic inferior vena cava(RIVC)begins at the base of renal vein and ends at the right atrium.Left,middle,right hepatic vein,inferior right hepatic vein etc.run into it.The major part of RIVC is wrapped in the caudate lobe of liver.It is adjacent to the abdominal trunk and vertebral body,having important anatomical significance.Inferior vena cava tumor thrombus includes two types.One is tumor thrombus formations in the RIVC.The other is direct invasion of tumor into RIVC wall.These two types correspond to different surgical treatment methods.The cancer thrombus in the vena cava can be treated by thrombus removal,while the tumor invading the vena cava wall requires resection of the invaded vascular wall and vascular reconstruction.Regardless of the types,improper surgical treatment is easy to cause injury and bleeding,leading to severe consequences.In this article,the main points of surgical management of different types of cancer thrombus in RIVC are introduced,providing methods to handle them.

关 键 词：肝肿瘤 肝后下腔静脉 癌栓 解剖 手术 

分 类 号：R735.7[医药卫生—肿瘤]