Beneficial use of the round ligament as a patch graft for vena cava reconstruction
Beneficial use of the round ligament as a patch graft for vena cava reconstruction
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DOI：
10.1007/s00534-007-1319-1
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发表时间：
2008-11-01
期刊：
影响因子：
--
通讯作者：
Hanaoka, Jun
中科院分区：
文献类型：
--
作者：
Ikegami, Toru;Shimada, Mitsuo;Hanaoka, Jun
是否有合适的血管移植物是部分腔静脉广泛肝切除术中的一个重要问题。该患者患有多结节性肝细胞癌，占据整个后段，腔静脉内有肿瘤血栓凸出。在剖腹手术中，获取一段圆韧带用作补片移植物。在不取下肝短静脉的情况下动员右侧肝脏后，通过悬挂操作完成实质切除。将肝腔静脉半完全侧夹，然后切除带有瘤栓的腔壁，实现整块切除。将所获得的圆韧带打开、修剪并缝合到腔静脉作为补片移植物，然后顺利再灌注。使用打开的圆韧带作为静脉补片移植物是腔静脉补片重建中简单可行的技术。
The availability of an appropriate vascular graft is a significant concern in an extensive hepatic resection with part of the vena cava.The patient had multinodular hepatocellular carcinoma, occupying the whole posterior segment with a tumor thrombus bulging inside the vena cava. At laparotomy, a segment of the round ligament was procured for use as a patch graft. After the mobilization of the right-side liver without taking down the short hepatic veins, parenchymal resection was completed with the use of a hanging maneuver. The hepatic vena cava was semitotally side-clamped, followed by resection of the caval wall with the tumor thrombus, resulting in an en-bloc resection. The procured round ligament was opened, trimmed, and sutured to the vena cava as a patch graft, followed by smooth reperfusion.The use of an opened round ligament as a venous patch graft is an easy and feasible technique in patch reconstruction of the vena cava.