Hayashi J, Ohzeki H, Tsuchida S, Fujita Y, Tatebe S, Namura O, Eguchi S, Iwafuchi M
Second Department of Surgery, University School of Medicine, Niigata, Japan.
Thorac Cardiovasc Surg. 1995 Jun;43(3):161-4. doi: 10.1055/s-2007-1013791.
Surgical management for cavoatrial involvement of malignant tumors and its outcome is reported on for 6 patients; their age ranged from 55 to 79 years and 5 were male and 1 female. The basic disease was renal cell carcinoma in 5 cases and adrenal leiomyosarcoma in 1. Intracaval tumor extension was diagnosed by computed tomography, magnet resonance imaging, digital subtraction angiography, and echocardiography. The tumor was resected together with adherant vena cava and invaded right-atrial wall, using cardiopulmonary bypass and normo- or mild-hypothermia in 5 patients. The caval defect needed to be reconstructed with a slit GORE-TEX vascular prosthesis in 3 patients. In all patients the tumor resections were successful and without major complications. All patients survived and are well from 4 to 52 months after the surgery. It is concluded that such cavoatrial extensions of malignant tumors can be safely and accurately resected with the aid of cardiopulmonary bypass, with favorable early and late outcomes in patients who have no distant metastatic lesions.
报告了6例恶性肿瘤侵犯腔房的手术治疗及其结果；患者年龄在55至79岁之间，5例为男性，1例为女性。基础疾病5例为肾细胞癌，1例为肾上腺平滑肌肉瘤。通过计算机断层扫描、磁共振成像、数字减影血管造影和超声心动图诊断腔静脉内肿瘤扩展。5例患者在体外循环和正常体温或轻度低温下，将肿瘤连同粘连的腔静脉和侵犯的右心房壁一并切除。3例患者的腔静脉缺损需要用带缝Gore-Tex血管假体重建。所有患者肿瘤切除均成功，无重大并发症。所有患者术后存活，术后4至52个月情况良好。结论是，对于无远处转移灶的患者，借助体外循环可安全、准确地切除此类恶性肿瘤的腔房扩展，早期和晚期效果良好。
