Mizuguchi Toru, Katsuramaki Tadashi, Morishita Kiyofumi, Kawamoto Masaki, Nobuoka Takayuki, Imamura Masato, Kimura Yasutoshi, Hirata Koichi
Department of Surgery I, Sapporo Medical University Hospital, Sapporo Medical University School of Medicine, Sapporo, Japan.
Dig Surg. 2006;23(1-2):115-8. doi: 10.1159/000094229. Epub 2006 Jun 27.
Hepatectomy for secondary liver cancer that has invaded the inferior vena cava (IVC) can be the only way to achieve long-term survival. We describe a method for hepatectomy combined with partial IVC resection without venous bypass circulation and an in situ graft-trimming method to avoid graft size mismatch after reconstruction. We carried out left hepatectomy extended to segment 1 with partial IVC resection first. During resection and reconstruction of the IVC, it was clamped below the right hepatic vein and above the inferior right hepatic vein to maintain systemic circulation. The graft was trimmed in situ, after a half running suture of the graft was finished to ensure the correct size. Preservation of both inferior right hepatic vein and right hepatic vein helps to maintain systemic circulation during reconstruction of the IVC. The in situ graft-trimming method is an easy and safe method to ensure the correct graft size after IVC reconstruction.
对于侵犯下腔静脉（IVC）的继发性肝癌，肝切除术可能是实现长期生存的唯一途径。我们描述了一种不进行静脉旁路循环的肝切除术联合部分IVC切除术的方法，以及一种原位移植修剪方法，以避免重建后移植大小不匹配。我们首先进行了向左肝叶延伸至第1段的肝切除术并部分切除IVC。在IVC切除和重建过程中，在右肝静脉下方和右下肝静脉上方进行钳夹，以维持体循环。在移植的半连续缝合完成后，在原位修剪移植，以确保尺寸正确。保留右下肝静脉和右肝静脉有助于在IVC重建过程中维持体循环。原位移植修剪方法是一种简单安全的方法，可确保IVC重建后移植尺寸正确。
