Nouh Mohammed Ahmed Abdel-Muneem, Inui Masashi, Kakehi Yoshiyuki
Department of Urology, Kagawa University, Faculty of Medicine, Kagawa, Japan.
Clin Med Oncol. 2008;2:247-56. doi: 10.4137/cmo.s464. Epub 2008 Mar 26.
The incidence of venous extension to the inferior vena cava (IVC) in renal cell carcinoma (RCC) is markedly increased recently mostly due to the advances in diagnostic modalities. Such vascular invasion implies a heightened biologic behavior and a surgical challenge during the course of treatment. In this study, we reviewed the classification guidelines, recent diagnostic tools and up-to-date therapeutic modalities for RCC with IVC tumor thrombi added to the prognostic significance regarding the pathologic nature of vascular invasion; cephalad extent of thrombi and any associated distant metastasis. Also, we are providing our suggestion regarding the use of angioscopy for removal of IVC thrombi in a relatively bloodless field without aggressive surgical manipulations or shunt techniques for maintenance of hemodynamic stability.
肾细胞癌（RCC）侵犯下腔静脉（IVC）的发生率近来显著增加，这主要归因于诊断方式的进步。这种血管侵犯意味着生物学行为的增强以及治疗过程中的手术挑战。在本研究中，我们回顾了RCC合并IVC瘤栓的分类指南、最新诊断工具和现代治疗方式，并阐述了血管侵犯的病理性质、瘤栓的头端范围以及任何相关远处转移的预后意义。此外，我们还就使用血管内镜在相对无血的视野中清除IVC瘤栓提出建议，而无需进行激进的手术操作或分流技术来维持血流动力学稳定。
