Dong M, Liang F, Song S
Department of Surgery, General Hospital of People's Liberation Army, Beijing 100853.
Zhonghua Wai Ke Za Zhi. 1998 Jan;36(1):23-5.
To improve the surgical resection rate of complicated retroperitoneal tumors which depends on handling of celiac major blood vessel.
219 retroperitoneal tumours were resected from 1990 to 1997. Eleven of them were resected in combination of resections and reconstructions of inferior vena cava (IVC) and renal veins (RV). IVC below RV was resected in 5 cases, IVC below liver with resections of right kidney in 3 cases, IVC above RV in 1 case, major partial resections of left RV with anastomosis to left ovarian vein in 2 cases, and 1 of them with IVC resection.
Follow-up showed transient bilateral lower limbs edema in 3 cases. The values of blood urea nitrogen and creatinine were normal after operations, no changes were found in the kidneys under ultrasonic examination.
As the left renal vein has many branches and constant anastomotic branches that connect with peripheral veins, it can be ligated proximally; and it even can be resected when at least one of its branches (routinely lift sexual gland vein) can be kept to maintain the blood circulation. Reconstruction of IVC and RV is usually not necessary after the resection of IVC, unless the bilateral renal veins were obstructed.
提高依赖于腹腔主要血管处理的复杂腹膜后肿瘤的手术切除率。
1990年至1997年共切除219例腹膜后肿瘤。其中11例在切除肿瘤的同时进行了下腔静脉（IVC）和肾静脉（RV）的切除与重建。5例切除了肾静脉下方的下腔静脉，3例切除了肝下方的下腔静脉并切除右肾，1例切除了肾静脉上方的下腔静脉，2例对左肾静脉进行大部切除并与左卵巢静脉吻合，其中1例还切除了下腔静脉。
随访显示3例出现短暂性双侧下肢水肿。术后血尿素氮和肌酐值正常，超声检查肾脏无变化。
由于左肾静脉有许多分支以及与外周静脉相连的恒定吻合支，可在近端结扎；甚至在其至少一个分支（通常为提睾静脉）得以保留以维持血液循环时，也可将其切除。切除下腔静脉后通常无需重建下腔静脉和肾静脉，除非双侧肾静脉受阻。
