Honda Haruto, Ueda Norichika, Takezawa Kentaro, Kato Taigo, Hatano Koji, Fukuhara Shinichiro, Nonomura Norio, Kawashima Atsunari
Department of Urology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.
Urol Case Rep. 2025 Feb 10;59:102982. doi: 10.1016/j.eucr.2025.102982. eCollection 2025 Mar.
We preoperatively evaluated the tumor thrombus of right renal cell carcinoma cT3cN0M0 extending close to the right atrium using abdominal ultrasound. We found that invasion of the inferior vena cava (IVC) by the tumor thrombus was limited to the caudal side of the hepatic vein. We clamped the caudal IVC, left renal, and hepatic veins but not the cranial IVC. Incising the IVC in this situation caused retrograde flow, moving the floating tumor thrombus caudally. This enabled rapid extraction of the tumor thrombus and cranial IVC clamping below the hepatic vein. Consequently, tumor thrombectomy was successfully performed without cardiopulmonary bypass.
我们术前使用腹部超声对右肾细胞癌cT3cN0M0且肿瘤血栓延伸至靠近右心房的患者进行了评估。我们发现肿瘤血栓对下腔静脉（IVC）的侵犯仅限于肝静脉尾侧。我们钳夹了下腔静脉尾侧、左肾静脉和肝静脉，但未钳夹下腔静脉头侧。在这种情况下切开下腔静脉会导致逆向血流，将漂浮的肿瘤血栓向尾侧移动。这使得能够快速取出肿瘤血栓并在肝静脉下方钳夹下腔静脉头侧。因此，在未进行体外循环的情况下成功实施了肿瘤血栓切除术。
