Boneschi M, Miani S, Erba M, Giuffrida G F, Giordanengo F
Instituto di Chirurgia Generale e Cardiovascolare, Università degli Studi, Milano.
Minerva Cardioangiol. 1995 Mar;43(3):91-5.
Clinical conditions requiring resection and replacement of the inferior vena cava (IVC) are rare and have included tumors, traumatic or iatrogenic injuries. Intraluminal extension or direct mural involvement of the IVC is seen with a variety of tumors: renal cell carcinomas, adrenal cortical tumors, leiomyosarcomas and pheochromocytomas. Surgical treatment requires tumor resection with simultaneous en bloc resection of the involved IVC. Resection of the lower and middle segments of IVC is possible in nearly all cases and surgical reconstruction is generally made with a polytetrafluoroethylene (PTFE) tube graft. Resection at suprahepatic vein level is indicated only rarely: tumor invasion of the suprahepatic veins require liver transplantation. Venous bypasses have lower patency rates than prosthetic replacement because of the low pressure and lower-flow of the venous system.
需要切除并置换下腔静脉（IVC）的临床情况很少见，包括肿瘤、创伤性或医源性损伤。多种肿瘤可出现下腔静脉腔内扩展或直接侵犯血管壁，如肾细胞癌、肾上腺皮质肿瘤、平滑肌肉瘤和嗜铬细胞瘤。手术治疗需要切除肿瘤并同时整块切除受累的下腔静脉。几乎在所有病例中都可以切除下腔静脉的下段和中段，手术重建通常使用聚四氟乙烯（PTFE）人工血管。仅在极少数情况下才需要在肝上静脉水平进行切除：肿瘤侵犯肝上静脉需要进行肝移植。由于静脉系统压力低、血流少，静脉旁路的通畅率低于人工血管置换。
