Should the inferior vena cava be reconstructed after resection for malignant tumors?
Should the inferior vena cava be reconstructed after resection for malignant tumors?
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DOI：
10.1016/j.amjsurg.2005.01.010
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发表时间：
2005-04-01
影响因子：
3
通讯作者：
Miyazaki, M
中科院分区：
文献类型：
--
作者：
Yoshidome, H;Takeuchi, D;Miyazaki, M
背景：下腔静脉环切术后的腔静脉置换术仍存在争议。本研究的目的是确定是否下腔静脉置换术应performed.Methods：我们回顾了36例下腔静脉切除术同时切除恶性肿瘤。我们的下腔静脉环形切除标准是肿瘤侵入血管壁的一半或更多周长，腔静脉壁的原发性肿瘤，或怀疑粘附在腔静脉壁上的巨大腔内癌栓。我们详细介绍了10例患者接受环切除下腔静脉。结果：大多数患者谁没有接受下腔静脉置换术表现出下肢肿胀的迹象，但一个持续的腿部水肿少尿。这位病人在手术前有不良的侧支循环和轻微的下腔静脉阻塞。两名接受下腔静脉置换术的患者没有静脉后遗症，虽然他们有不良的侧支循环术前surgery.Conclusion：下腔静脉环切后腔静脉置换术可能是必要的患者术前侧支循环发展不良或谁少尿或术中血流动力学不稳定。(c)2005 Excerpta Medica Inc. All rights reserved.
Background: Caval replacement after circumferential resection of the inferior vena cava remains controversial. The aim of the current study is to determine whether or not inferior vena cava replacement should be performed.Methods: We reviewed 36 cases undergoing resection of the inferior vena cava concomitant with resection of malignant neoplasms. Our criteria for circumferential resection of the inferior vena cava were half or more of the circumference of the vessel wall invaded by tumor, a primary tumor of the caval wall, or massive intraluminal tumor thrombus suspected of adhering to the caval wall. We detailed 10 patients undergoing circumferential resection of the inferior vena cava.Results: Most of patients who did not undergo replacement of the inferior vena cava showed no sign of swelling of the lower limbs, but one showed persistent leg edema with oliguria. This patient had poor development of collateral circulation and mild obstruction of the inferior vena cava before surgery. Two patients who underwent replacement of inferior vena cava had no venous sequelae, although they had poor development of collateral circulation before surgery.Conclusion: Caval replacement after circumferential resection of the inferior vena cava may be necessary in patients who have preoperative poor development of collateral circulation or who have oliguria or unstable hemodynamics intraoperatively. (c) 2005 Excerpta Medica Inc. All rights reserved.