Bacalbasa Nicolae, Balescu Irina, Ichim Florin, Barbu Ion, Ristea Alexandru, Lazea Razvan, Danciuc Ioana, Popa Ioana, Magdoiu Ovidiu, Smira Gabriela, Diaconu Camelia, Furtunescu Florentina, Stiru Ovidiu, Savu Cornel, Stoica Claudia, Brasoveanu Vladislav, Ursut Bogdan, Al Aloul Adnan
Department of Visceral Surgery, Center of Excellence in Translational Medicine "Fundeni" Clinical Institute, 022328 Bucharest, Romania.
Department of Obstetrics and Gynecology, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania.
Healthcare (Basel). 2021 Oct 19;9(10):1396. doi: 10.3390/healthcare9101396.
BACKGROUND/AIM: Locally advanced liver tumours with vascular invasion have been considered for a long period of time as unresectable lesions, so the patient was further deferred to oncology services for palliation. However, improvement of the surgical techniques and the results reported so far came to demonstrate that extended hepatic and vascular resections might be safely performed in such cases and might significantly improve the long-term outcomes.
A 61-year-old patient was diagnosed with a caudate lobe tumour invading the inferior cava vein and the right hepatic pedicle.
The patient was successfully submitted to surgery, and an extended right hepatectomy en bloc with cava vein resection was performed; the continuity of the cava vein was re-established by the placement of a synthetic graft. The postoperative outcome was uneventful.
Although initially considered as a formal contraindication for resection, vascular invasion of the greater vessels should not preclude surgery if complete resection is achievable.
背景/目的：长期以来，伴有血管侵犯的局部晚期肝肿瘤一直被视为不可切除的病变，因此患者被进一步转至肿瘤科进行姑息治疗。然而，手术技术的改进以及目前所报道的结果表明，在这类病例中可以安全地进行扩大的肝脏和血管切除术，并且可能显著改善长期预后。
一名61岁患者被诊断为尾状叶肿瘤侵犯下腔静脉和右肝蒂。
患者成功接受手术，实施了扩大的右肝整块切除并同时切除腔静脉；通过植入人工血管重建腔静脉的连续性。术后恢复顺利。
尽管大血管侵犯最初被视为手术切除的绝对禁忌证，但如果能够实现完整切除，则不应排除手术。
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