腹腔镜根治性肾切除术联合二级腔静脉血栓切除术：猪的生存研究

Laparoscopic radical nephrectomy with level II vena caval thrombectomy: survival porcine study.

作者信息

Fergany Amr F, Gill Inderbir S, Schweizer Dana K, Kaouk Jihad H, ElFettouh Hazem Abou, Cherullo Edward E, Meraney Anoop M, Sung Gyung Tak

机构信息

Section of Laparoscopic and Minimally Invasive Surgery, Urological Institute and the Minimally Invasive Surgery Center, Cleveland Clinic Foundation, Ohio 44195, USA.

出版信息

J Urol. 2002 Dec;168(6):2629-31. doi: 10.1016/S0022-5347(05)64232-2.

DOI:10.1016/S0022-5347(05)64232-2

PMID:12441998

Abstract

PURPOSE

Inferior vena caval tumor thrombus due to renal cell carcinoma generally precludes laparoscopic techniques for radical nephrectomy. We developed the technique of laparoscopic infrahepatic (level II) inferior vena caval thrombectomy in a survival porcine model.

MATERIALS AND METHODS

Of the 7 female pigs used in the study 2 were acute and 5 were chronic animals which were allowed to survive for 6 weeks postoperatively. Laparoscopic right radical nephrectomy and inferior vena caval thrombectomy were performed in accordance with established open surgical principles, including vascular control and intracorporeal reconstruction of the vena cava and left renal vein.

RESULTS

Complete removal of the simulated caval thrombus was successful in each case without intraoperative or postoperative complications. Average operative time was 160 minutes. Postoperatively inferior venacavography showed a patent vena cava and left renal vein in all animals.

CONCLUSIONS

Laparoscopic radical nephrectomy was successful in an animal model simulating renal cell carcinoma with infrahepatic vena caval tumor thrombus. Clinical application of this technique appears possible.

摘要