Ehrlich Yaron, Kedar Daniel, Zelikovski Avigdor, Konichezky Miriam, Baniel Jack
Department of Urology, Rabin Medical Center, Petah Tiqwa, Israel.
Urology. 2009 Feb;73(2):442.e17-9. doi: 10.1016/j.urology.2008.02.054. Epub 2008 Apr 24.
We present our experience with inferior vena cava (IVC) reconstruction in patients undergoing post-chemotherapy retroperitoneal lymph node dissection (PC-RPLND) due to metastatic germ cell tumor. Four patients underwent IVC reconstruction with a prosthetic graft. Early postoperative leg edema was prevented in all 4. Long-term graft patency was maintained in 3 patients, who remained free of chronic venous disorders for a median follow-up of 19 months (range of 13-55 months). In a fourth patient, graft occlusion was noted during follow up, caused by compression of the graft by a recurrent tumor. We conclude that when resection of the IVC is indicated during PC-RPLND, replacement by a prosthetic graft may prevent immediate postoperative leg edema and later chronic venous insufficiency.
我们介绍了因转移性生殖细胞肿瘤接受化疗后腹膜后淋巴结清扫术（PC-RPLND）的患者进行下腔静脉（IVC）重建的经验。4例患者接受了人工血管移植进行IVC重建。所有4例患者术后早期均未出现腿部水肿。3例患者长期保持人工血管通畅，中位随访19个月（13 - 55个月），均未出现慢性静脉疾病。第4例患者在随访期间发现人工血管闭塞，原因是复发肿瘤压迫人工血管。我们得出结论，在PC-RPLND期间如需切除IVC，采用人工血管置换可预防术后早期腿部水肿及后期慢性静脉功能不全。
