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肾母细胞瘤合并心内扩展导致动态三尖瓣梗阻:麻醉挑战。

Wilm's tumor with intracardiac extension causing dynamic tricuspid valve obstruction: An anesthetic challenge.

作者信息

Kajal Kamal, Munirathinam Ganesh Kumar, Mandal Banashree, Gandhi Komal, Singh Harkant, Kanojia Ravi

机构信息

Department of Anaesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

Department of Cardiothoracic and Vascular surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

出版信息

Saudi J Anaesth. 2018 Apr-Jun;12(2):321-323. doi: 10.4103/sja.SJA_472_17.

Abstract

Wilms' tumor (WT) is the most common pediatric renal tumor that often spreads to inferior vena cava and sometimes up to right atrium (RA). We describe successful management of 3-year-old child diagnosed with WT having extension up to RA. He was operated under cardiopulmonary bypass and extubated on postoperative day 2 and discharged. Perioperative anesthesia concerns were shock from dynamic tricuspid valve obstruction, intraoperative massive blood loss, and a higher risk of pulmonary thromboembolism during tumor manipulation.

摘要

肾母细胞瘤(WT)是最常见的小儿肾肿瘤,常扩散至下腔静脉,有时甚至可至右心房(RA)。我们描述了一名3岁诊断为WT且肿瘤已扩展至RA的患儿的成功治疗过程。他在体外循环下接受手术,术后第2天拔管并出院。围手术期麻醉方面的问题包括动态三尖瓣梗阻引起的休克、术中大量失血以及肿瘤操作过程中肺血栓栓塞的较高风险。

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