Gotoh M, Monden M, Sakon M, Kanai T, Umeshita K, Ikeda H, Mori T
Department of Surgery II, Osaka University Medical School, Japan.
Arch Surg. 1992 Oct;127(10):1213-5. doi: 10.1001/archsurg.1992.01420100071012.
We developed a new method that provides a wide retroperitoneal irradiation field for patients with cancer of the pancreas in whom a long invaded portal vein is resected during intraoperative radiotherapy. This method involves the use of a venous bypass with a heparinized catheter that does not require systemic anticoagulation or a pump. Anastomosis is completed after intraoperative radiotherapy. Mean (+/- SD) duration of the venous bypass was 3.0 +/- 1.5 hours (range, 2.0 to 6.6 hours), during which no abnormalities of systemic blood pressure, heart rate, and electrocardiographic activity and no signs of congestion of the intestines were observed. Eleven patients were treated with this method, and no complications ascribed to intraoperative radiotherapy or venous bypass were found. We recommend this method as safe and simple for expanding the irradiation field for intraoperative radiotherapy in patients with pancreatic cancer in whom the portal vein is resected.
我们开发了一种新方法，可为胰腺癌患者提供广阔的腹膜后照射野，这些患者在术中放疗期间需切除受侵的长门静脉。该方法采用带肝素化导管的静脉搭桥术，无需全身抗凝或使用泵。术中放疗后完成吻合。静脉搭桥术的平均（±标准差）持续时间为3.0±1.5小时（范围为2.0至6.6小时），在此期间未观察到全身血压、心率和心电图活动异常，也未出现肠道充血迹象。11例患者采用该方法治疗，未发现与术中放疗或静脉搭桥术相关的并发症。对于门静脉被切除的胰腺癌患者，我们推荐这种安全简单的方法用于扩大术中放疗的照射野。
