Kuri Michioki, Kambara Noriko, Baba Mika, Nakagawa Masashi, Mammoto Tadanori, Tanigami Hironobu, Kishi Yoshihiko
Department of Anesthesiology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka 537-8511.
Masui. 2004 Feb;53(2):191-4.
A 43-year-old female with a huge myoma uteri was scheduled for a simple total hysterectomy. However, there was massive penetration of the tumor into the retroperitoneum, and her first operation failed because we had no advance information on its posterior aspect. Angiography was done to obtain this information. She rested on bed until the day after the first operation and angiography. MRI, performed again due to early growing tumor, revealed deep vein thrombi in the left iliac vein to the left femoral vein which the last MRI had not shown. Therefore, just before the second operation a temporary vena-cava filter was inserted, to prevent acute pulmonary thromboembolism. The operation was performed without incident. The filter captured some thrombi, and these were resolved by urokinase postoperatively. No symptomatic pulmonary thromboembolism was recognized during the perioperative period. The postoperative course was uneventful.
一名43岁患有巨大子宫肌瘤的女性计划接受单纯全子宫切除术。然而,肿瘤大量侵入腹膜后间隙,由于我们事先对肿瘤后方情况了解不足,她的首次手术失败了。于是进行了血管造影以获取这方面信息。她在首次手术和血管造影后的次日一直卧床休息。由于肿瘤早期生长,再次进行的MRI检查显示左髂静脉至左股静脉存在深静脉血栓,而上次MRI检查并未发现。因此,在第二次手术前临时置入了下腔静脉滤器,以预防急性肺血栓栓塞。手术顺利完成。滤器捕获了一些血栓,术后通过尿激酶使其溶解。围手术期未发生有症状的肺血栓栓塞。术后恢复过程顺利。