Cerwinka Wolfgang H, Ciancio Gaetano, Salerno Thomas A, Soloway Mark S
Department of Urology, University of Miami Miller School of Medicine, Miami, Florida, USA.
Urology. 2005 Dec;66(6):1319. doi: 10.1016/j.urology.2005.06.098.
We report a case of a 50-year-old man with right renal cell cancer extending into the inferior vena cava, invading the right atrial wall, and Budd-Chiari syndrome. Because of the patient's coagulopathy and extensive venous collateralization, cardiopulmonary bypass and deep hypothermic circulatory arrest were avoided. Through an abdominal approach, the diaphragm was incised and the right atrium pulled into the abdomen and clamped. The invasive tumor thrombus was sharply excised off the atrial wall. If serious medical conditions do not permit the use of cardiopulmonary bypass, it is technically feasible to excise a wall-invasive atrial tumor thrombus off-pump.
我们报告一例50岁男性患者，患有右肾细胞癌，肿瘤已延伸至下腔静脉，侵犯右心房壁，并伴有布加综合征。由于患者存在凝血功能障碍及广泛的静脉侧支循环，故避免了体外循环和深低温停循环。通过腹部入路，切开膈肌，将右心房牵入腹部并钳夹。将侵袭性肿瘤血栓从心房壁上锐性切除。如果严重的内科情况不允许使用体外循环，在非体外循环下切除侵犯心房壁的肿瘤血栓在技术上是可行的。
