Multivisceral Ex Vivo Surgery for Tumors Involving Celiac and Superior Mesenteric Arteries
Multivisceral Ex Vivo Surgery for Tumors Involving Celiac and Superior Mesenteric Arteries
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DOI：
10.1111/j.1600-6143.2011.03945.x
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发表时间：
2012-05-01
影响因子：
8.8
通讯作者：
Emond, J.
中科院分区：
文献类型：
--
作者：
Kato, T.;Lobritto, S. J.;Emond, J.
腹部肿瘤同时累及腹腔动脉根部和上级肠系膜动脉根部被认为是不能用传统的外科方法切除的。我们进行了三例多脏器离体手术，包括暂时切除整个腹部脏器，然后进行血管重建，离体肿瘤切除和切除器官的自体移植。我们在所有病例中实现了肿瘤完全切除，边缘阴性。所有患者在17个月、27个月和38个月随访时均存活，迄今为止无肿瘤复发。术后并发症包括腹泻、Oddi括约肌功能障碍和动脉狭窄;所有这些都对直接治疗有反应。多脏器离体手术应用死亡供体多脏器移植技术是可行的，以实现局部控制，否则无法切除的腹部肿瘤。这种手术最适合于因位置和血管受累而无法切除的局部浸润性肿瘤。
Abdominal tumors involving both roots of the celiac and superior mesenteric artery are deemed unresectable by conventional surgical methods. We performed three cases of multivisceral ex vivo surgery involving temporary removal of the entire abdominal viscera followed by vascular reconstruction, ex vivo tumor resection and autotransplantation of excised organs. We achieved a complete tumor resection with negative margins in all cases. All patients have survived with no tumor recurrence to date at 17-, 27- and 38-month follow-up. Postoperative complications included diarrhea, sphincter of Oddi dysfunction and arterial stenosis; all responded to directed treatments. Multivisceral ex vivo surgery applying techniques of deceased donor multivisceral transplantation is feasible in achieving local control of otherwise unresectable abdominal tumors. This surgery is best suitable for locally invasive tumors unresectable because of location and vascular involvement.