CAJ | 학술논문

肾母细胞瘤合并下腔静脉瘤栓形成,通常可经静脉切开取出瘤栓,但肾动脉开口以上的慢性完全性栓塞,已有充足时间建立侧支循环,尤其当切除右肾肿瘤时,在肾血管水平以上结扎或切除一段下腔静脉,不会导致严重后果.本文报导四例的处理经验,认为术前下腔静脉造影对判断手术困难的病例术中是否会发生意外很有意义,必要时将下腔静脉结扎或切除是切实可行的.
신모세포류합병하강정맥류전형성,통상가경정맥절개취출류전,단신동맥개구이상적만성완전성전새,이유충족시간건립측지순배,우기당절제우신종류시,재신혈관수평이상결찰혹절제일단하강정맥,불회도치엄중후과.본문보도사례적처리경험,인위술전하강정맥조영대판단수술곤난적병례술중시부회발생의외흔유의의,필요시장하강정맥결찰혹절제시절실가행적.
Girl of 12,with a large Wilms'tumor of right kidney,came for tumor excision.At operation,it was found that a segment of vena cava had been resected together with the tumor,and the left renal vein had been ligated at the same time.However,renal function remained unchanged and patient recovered from the operation uneventfully.In 3 other similar cases with tumor embolus in vena cava,it was found that no blood returned from the renal vein of the uneffected kidney after embolectomy.Evidently,the collaterals have developed during the occlusion of the vena cava.Therefore,it can be concluded that,in difficult cases,a tumor occluded vena cava can be resected with the diseased kidney without damaging the kidney function of the other side.