Department of General Surgery, Shanghai Fourth People's Hospital Affiliated to Tongji University School of Medicine, Shanghai, 200081, China.
The Graduate School, Qinghai University, Xining, 810000, China.
Sci Rep. 2019 Jul 1;9(1):9419. doi: 10.1038/s41598-019-45968-5.
Patients with hepatic alveolar echinococcosis (HAE) infringing on the inferior vena cava (IVC) have a poor prognosis when radical resection cannot be performed because curative resection is limited by IVC reconstruction. There is little information concerning combined resection of the liver and the IVC. This study explored a novel treatment method for HAE infringing on the IVC and evaluated the safety and feasibility of combined resection of the liver and the IVC. A total of 13 patients were treated with liver resection combined with IVC resection for end-stage HAE between January 2016 and July 2018 at the Affiliated Hospital of Qinghai University. The demographic, clinical, and follow-up data were collected and analysed. The 13 patients underwent resection of the IVC without reconstruction. Of these, 3 exhibited oedema of both lower limbs and the scrotum (23.1%), 2 exhibited pneumothorax (15.4%), 1 exhibited bile leakage (7.7%), 1 exhibited bacteraemia (7.7%), and 1 developed abdominal haemorrhage that was stopped with conservative treatment (7.7%). There was 1 case of operation-related mortality because of upper gastrointestinal haemorrhage (7.7%), and no patients developed recurrence or had residual lesions. Liver resection combined with IVC resection is effective and feasible for patients with HAE infringing on the IVC.
患有侵犯下腔静脉(IVC)的肝泡状棘球蚴病(HAE)的患者,如果无法进行根治性切除术,预后较差,因为根治性切除术受到 IVC 重建的限制。关于联合切除肝脏和 IVC 的信息很少。本研究探讨了一种侵犯 IVC 的 HAE 的新治疗方法,并评估了联合切除肝脏和 IVC 的安全性和可行性。2016 年 1 月至 2018 年 7 月,青海大学附属医院对 13 例终末期 HAE 患者行肝切除术联合 IVC 切除术治疗。收集并分析了这些患者的人口统计学、临床和随访数据。这 13 例患者均未行 IVC 重建而接受了 IVC 切除术。其中,3 例出现下肢和阴囊水肿(23.1%),2 例出现气胸(15.4%),1 例出现胆漏(7.7%),1 例出现菌血症(7.7%),1 例发生腹部出血,经保守治疗后停止(7.7%)。1 例因上消化道出血而与手术相关的死亡(7.7%),无患者复发或有残留病变。肝切除术联合 IVC 切除术对侵犯 IVC 的 HAE 患者有效且可行。