Giuliani L, Martorana G, Giberti C, Pescatore D
Minerva Chir. 1981 Mar 31;36(6):401-8.
Personal experience in the surgical management of 15 cases of renal adenocarcinoma with neoplastic thrombosis of the vena cava inferior is described, and an account is given of the procedures adopted in accordance with the degree of endocavitary extension of the tumour. Emphasis is also placed on the need to ensure, as in all cases of nephrectomy for tumours, "neoplastic asepsis" by means of a preliminary vascular stage with the compartment intact. For this purpose, it is felt that sufficient preoperative angiographic evaluation of the intracavitary tumour is essential, coupled with absolute intraoperative control of the vena cava and/or right atrium proximally to the thrombus, to prevent the intraoperative mobilisation of neoplastic embolisms.
本文描述了15例伴有下腔静脉肿瘤血栓形成的肾腺癌手术治疗的个人经验,并阐述了根据肿瘤腔内扩展程度所采取的手术步骤。同时强调,与所有肿瘤性肾切除术一样,需要通过在保留腔室的情况下进行初步血管处理阶段来确保“肿瘤无菌”。为此,认为术前对腔内肿瘤进行充分的血管造影评估至关重要,同时术中要对血栓近端的下腔静脉和/或右心房进行绝对控制,以防止术中肿瘤栓子的移动。