下腔静脉-右心房自然转流技术在下腔静脉瘤栓切除术中的应用

Caval-atrial venovenous bypass technique in vena caval thrombectomy for renal and adrenal carcinomas with inferior vena cava involvement

目的 探讨下腔静脉 右心房自然转流技术在下腔静脉瘤栓切除术中的应用价值。 方法 报告 4例肾或肾上腺恶性肿瘤合并下腔静脉瘤栓患者的临床资料以及术中应用下腔静脉 右心房自然转流技术行下腔静脉瘤栓切除的方法。 结果 4例转流后下腔静脉阻断时的各项血液动力学指标无明显变化。 3例肾肿瘤患者下腔静脉瘤栓及原发肿瘤完全切除 ,1例肾上腺恶性肿瘤患者下腔静脉瘤栓大部分切除。术后恢复良好 ,无并发症。 结论 下腔静脉 右心房自然转流技术是下腔静脉瘤栓切除术中安全简便。

Objective To assess the value of caval-atr ial venovenous bypass technique in resection of tumor thrombus for renal or adr enal carcinomas with inferior vena cava involvement. Methods From Mar.to Aug.of 2000,4 patients with renal or adrenal carcinoma extendi ng into inferior vena cava were admitted and evaluated.Radical nephrectomy and v ena cava thrombectomy were performed with the use of caval-atrial venovenous by pass technique. Results There was no significant change of hemodynamic parameters during vena cava thrombectomy.A part of tumor thrombu s in 1 case was left in situ because of its compact adhesion to the wall of infe rior vena cava.The tumor thrombus in inferior vena cava were completely removed in the other 3. Conclusions Caval-atrial venovenous byp ass technique is a simple and safe method during vena cava thrombectomy.