A case report of hepatocellular carcinoma derived from Rastelli procedure-related congestive liver disease
A case report of hepatocellular carcinoma derived from Rastelli procedure-related congestive liver disease
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Rastelli手术相关充血性肝病所致肝细胞癌一例报告
DOI：
10.1007/s12328-021-01488-2
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发表时间：
2021
影响因子：
1
通讯作者：
Eguchi Hidetoshi
中科院分区：
文献类型：
--
作者：
Sakano Yoshihiro;Noda Takehiro;Kobayashi Shogo;Iwagami Yoshifumi;Yamada Daisaku;Tomimaru Yoshito;Gotoh Kunihito;Umeshita Koji;Doki Yuichiro;Eguchi Hidetoshi
儿童先天性心脏病的预后有所改善，但成年后的晚期并发症正成为一个重要问题。先天性心脏病手术后的一个晚期并发症是充血性肝病，导致肝硬化和肝细胞癌（HCC）。Rastelli手术是治疗大动脉转位的手术方法之一。我们报告了第一例肝细胞癌，患者为41岁男性，源于Rastelli手术相关的充血性肝病。患者在2岁时接受了Rastelli手术，并在10岁和35岁时因右心室流出道阻塞接受了右心室流出道重建。在41岁时，通过计算机断层扫描检测到肝脏肿瘤。腹部增强计算机断层扫描显示，早期在第2节部分富血供肿瘤，晚期洗脱。患者被诊断为HCC，并接受了肝左外段切除术、脾切除术和胃部分切除术。患者于术后第28天出院，无术后并发症。在Rastelli手术后患者的管理中，即使患者接受了右心室流出道重建，对充血性肝病和HCC发展的监测也很重要。
The prognosis of congenital heart disease in children has improved, but late complications in adulthood are becoming an important problem. One late complication after congenital heart surgery is congestive liver disease, leading to liver cirrhosis and hepatocellular carcinoma (HCC). The Rastelli procedure is one of the surgical methods for transposition of the great arteries. We present the first case of HCC derived from Rastelli procedure-related congestive liver disease in a 41-year-old male. The patient underwent the Rastelli operation at 2 years of age and right ventricular outflow tract reconstruction at 10 and 35 years of age due to right ventricular outflow tract obstruction. At 41 years of age, a hepatic tumor was detected by computed tomography. Abdominal enhancing computed tomography revealed a partially hypervascular tumor in segment 2 in early phase and wash-out in late phase. The patient was diagnosed with HCC and underwent left lateral segmentectomy of the liver, splenectomy, and partial gastrectomy. The patient was discharged on the 28th postoperative day without postoperative complications. In the management of patients after the Rastelli operation, surveillance for congestive liver disease and HCC development is important, even if the patients have undergone right ventricular outflow tract reconstruction.