Devascularization of the superior mesenteric vein without reconstruction during surgery for retroperitoneal liposarcoma: A case report and review of literature.
Devascularization of the superior mesenteric vein without reconstruction during surgery for retroperitoneal liposarcoma: A case report and review of literature.
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腹膜后脂肪肉瘤手术中肠系膜上静脉断流而不重建：一例报告并文献复习
DOI：
10.3748/wjg.v24.i22.2406
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发表时间：
2018-06-14
影响因子：
4.3
通讯作者：
Liu C
中科院分区：
文献类型：
--
作者：
Miao RC;Wan Y;Zhang XG;Zhang X;Deng Y;Liu C
1例61岁女性慢性B型肝炎病毒感染患者在社区医院被诊断为脂肪肉瘤。细针穿刺活检证实了分化良好的脂肪肉瘤的诊断。腹部CT血管造影（CTA）显示肿块粘附并压迫上级肠系膜静脉（SMV）的主干和分支，尤其是回结肠静脉，血管重建扫描时可见侧支循环。切除腹部脂肪肉瘤。由于侧支循环，我们尝试了SMV的断流术，并切除了侵蚀的SMV。术后20 d行CTA检查，显示SMV消失。血管重建后SMV侧支循环和肠系膜下静脉明显改善。除了短暂性胃麻痹外，患者术后病程平稳。术后20个月，患者出现脂肪肉瘤复发。她接受了肿瘤切除术，切除远端小肠和右半结肠。我们了解到：（1）在不使用静脉移植物的情况下，直接行主SMV主干的断流术是可能的。侧支循环的存在可以提高根治性手术的成功率，预防术后严重并发症的发生。此外，（2）本例病例证实了三维重建的临床价值。
A 61-year-old female patient with chronic hepatitis B virus infection was diagnosed with liposarcoma in a community hospital. Fine needle aspiration biopsy confirmed the diagnosis of well-differentiated liposarcoma. Abdominal computed tomographic angiography (CTA) showed that the mass adhered to and constricted the main trunk and branch of the superior mesenteric vein (SMV), especially the ileocolic vein, and collateral circulation was observed during the vascular reconstruction scan. The abdominal liposarcoma was resected. Because of the collateral circulation, devascularization of the SMV was attempted, and we resected the eroded SMV. The condition of the blood vessels was evaluated 20 d after surgery using CTA, which showed that the SMV had disappeared. Significant improvements in SMV collateral circulation and the inferior mesenteric vein were observed after vascular reconstruction. The patient had an uneventful postoperative course except for transient gastroplegia. Twenty months after surgery, the patient had a recurrence of liposarcoma. She underwent tumor resection to remove the distal small intestine and right hemicolon. We learned that (1) direct devascularization of the main SMV trunk without a vein graft is possible. The presence of collateral circulation can increase the success rate of patients undergoing radical surgery and prevent the occurrence of serious postoperative complications. In addition, (2) this case demonstrated the clinical value of 3D reconstruction.
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DOI：
10.1200/jco.2017.74.9598
发表时间：
2018-01-10
期刊：
Journal of clinical oncology : official journal of the American Society of Clinical Oncology
影响因子：
--
作者：
Lee ATJ;Thway K;Huang PH;Jones RL
通讯作者：
Jones RL
影响因子：
2.3
作者：
Lee HS;Yu JI;Lim DH;Kim SJ
通讯作者：
Kim SJ
影响因子：
9.6
作者：
Ecker, B. L.;Peters, M. G.;Karakousis, G. C.
通讯作者：
Karakousis, G. C.
影响因子：
6.2
作者：
Jeon, Hoonbae;McHugh, Patrick P.;Ranjan, Dinesh
通讯作者：
Ranjan, Dinesh
影响因子：
0.5
作者：
Mani, Vishnu R.;Ofikwu, Godwin;Safavi, Ali
通讯作者：
Safavi, Ali