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1例经腰穿途径置入中心静脉导管化疗治疗的食管癌合并上腔静脉综合征患者。

A case of esophageal cancer with superior vena cava syndrome treated with chemotherapy via a central venous port placed by translumbar approach.

作者信息

Maruo Kazuya, Yoshida Juichiro, Nishimura Takeshi, Fujii Hideki, Tomatsuri Naoya, Yamashita Masanori, Ichijo Yusuke, Sano Yuko, Okuyama Yusuke, Sato Hideki

机构信息

Department of Gastroenterology and Hepatology, Japanese Red Cross Society Kyoto Daiichi Hospital, 15-749 Honmachi, Higashiyama-Ku, Kyoto, 605-0981, Japan.

Department of Oncology, Japanese Red Cross Society Kyoto Daiichi Hospital, 15-749 Honmachi,Higashiyama-Ku, Kyoto, 605-0981, Japan.

出版信息

Clin J Gastroenterol. 2025 Jun;18(3):448-454. doi: 10.1007/s12328-025-02121-2. Epub 2025 Apr 1.

Abstract

Superior vena cava syndrome (SVCS) is a serious condition that complicates the placement of central venous access port (CV port) in cancer patients. This report highlights the successful placement of a CV port by translumbar approach in a patient with advanced esophageal carcinoma complicated by SVCS. The patient was an 80-year-old woman whose tumor had invaded the superior vena cava (SVC) through the azygos vein, necessitating stent placement in the SVC. Subsequently, a CV port was implanted in the inferior vena cava using a translumbar approach, allowing the initiation of chemotherapy. The patient underwent nine cycles of FOLFOX followed by four cycles of nivolumab. To address worsening dysphagia, an esophageal stent was placed, disease progression was confirmed during treatment. The patient then transitioned to best supportive care. The patient passed away 432 days after the CV port placement. Notably, no port-related complications were observed throughout the course of treatment, underscoring the feasibility and safety of the translumbar approach in patients with SVCS.

摘要

上腔静脉综合征(SVCS)是一种严重的病症,会使癌症患者中心静脉通路端口(CV端口)的放置变得复杂。本报告强调了在一名患有晚期食管癌并伴有SVCS的患者中,通过经腰途径成功放置CV端口的情况。该患者为一名80岁女性,其肿瘤通过奇静脉侵犯了上腔静脉(SVC),因此需要在上腔静脉放置支架。随后,采用经腰途径在下腔静脉植入了CV端口,从而得以开始化疗。该患者接受了9个周期的FOLFOX方案治疗,随后接受了4个周期的纳武单抗治疗。为解决吞咽困难加重的问题,放置了食管支架,治疗期间证实疾病进展。该患者随后转为最佳支持治疗。在CV端口放置432天后,患者去世。值得注意的是,在整个治疗过程中未观察到与端口相关的并发症,这突出了经腰途径在SVCS患者中的可行性和安全性。

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