Tomita Yoshihiko, Kurumada Shigenori, Takahashi Kota, Ohzeki Hajime
Division of Urology, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental Sciences, Asahimachi 1, Niigata 951-8510, Japan.
J Clin Ultrasound. 2003 Jun;31(5):274-7. doi: 10.1002/jcu.10165.
We report the case of a 58-year-old woman with renal cell carcinoma in whom real-time transesophageal sonographic monitoring of the tumor thrombus in the inferior vena cava provided dynamic information, allowing us to determine the appropriate operative procedure to use. Observation of the thrombus throughout the operation showed that mobilization of the liver resulted in compression of the inferior vena cava against the spine, increasing the risk of migration of the tumor thrombus and reinforcing the need to maintain adequate positioning of the liver to prevent such compression. The surgery was completed successfully, and the patient's postoperative course was uneventful. We recommend the use of real-time transesophageal sonographic monitoring of the tumor thrombus during such surgical procedures.
我们报告了一例58岁肾细胞癌女性患者的病例，术中经食管实时超声监测下腔静脉内的肿瘤血栓，提供了动态信息，使我们能够确定合适的手术方式。整个手术过程中对血栓的观察显示，肝脏的游离会导致下腔静脉受压于脊柱，增加肿瘤血栓迁移的风险，这进一步强调了保持肝脏适当位置以防止这种压迫的必要性。手术成功完成，患者术后恢复顺利。我们建议在这类手术中使用经食管实时超声监测肿瘤血栓。
