肾或肾上腺肿瘤伴下腔静脉瘤栓的手术治疗

Surgical Treatment of renal or adrenal tumor with inferior vena cava tumor thrombus

目的 小结肾或肾上腺肿瘤伴下腔静脉瘤栓病人的手术经验 ,探讨有关心血管外科技术的改进。方法 1 999年 6月至 2 0 0 2年 5年完成该类手术 1 2例 ,在术前准备、切口与显露、心血管外科技术、体外循环方式等方面 ,结合临床经验 ,提出一些改进措施。结果 手术效果良好 ,无手术死亡。随访1 4～ 35个月 ,结果比较满意 ,仅 1例恶性纤维组织细胞瘤术后出院 1个月死亡。结论 对有明确适应证的病例 ,经充分准备 ,多科室密切合作手术治疗 ,可以取得良好的疗效。远期疗效评估有待更长时间的随访。

Objective: Primarily discuss the application of cardiac surgical technique in surgical treatment on renal or adrenal tumor with the inferior vena cava involvement. Methods: Various methods were illustrated in terms of the intra operative technique of cardiovascular surgery, especially in the aspects of pre operative preparation, operative technique, and various types of extracorporeal circulation. Results: All except one death 1 month after operation suffering from sarcoma of the kidney had good outcome and were follow up (14～35 months). Conclusion: Good outcomes could be obtained in well selected and adequately prepared cases with the firm cooperation of multiple departments. A longer follow up may lead to a more accurate and reliable long term evaluation.