紧贴下腔静脉肝血管瘤的手术治疗

目的探讨紧贴下腔静脉（inferior vena cava,IVC）的肝血管瘤的手术治疗。方法回顾性分析2003年1月至2005年9月手术切除的30例紧贴IVC的肝血管瘤的临床资料,利用第三肝门解剖法、肝静脉结扎阻断法、半肝血流阻断法3种方法,切除紧贴IVC的肿瘤。结果30例肝血管瘤均安全切除,IVC修补5例,术中出血量100～5000ml。术后无明显并发症发生。随访至今,1例血管瘤复发,其余均良好。结论把肿瘤的流入、流出道在肝外预先处理,可以减少手术的风险。术中注意肿瘤的显露,力争肿瘤的完整切除,避免流出道梗阻,肝脏创面渗血不止等紧急情况下压纱布也是一种有效的选择。

Operation of hemangioma adhering to inferior vena cava

Objective To analyze the operation of hemangioma adhering to inferior vena cava. Methods The clinical data of 30 cases of hemangioma adhering to inferior vena cava were retrospectively analyzed, which were collected from January 2003 to September 2001. The operation was performed with levis application of the third hepatic portal dissection, hepatic veins ligation and half liver blood flow blockage, so as to incise the hemanginoma safely. Results Hemangioma was resected safely in all cases, of which 5 cases restored inferior vena cava, with hemorrhage volume for 100-5 000 ml during operation and with no complications occurred. Follow-up till now showed fine results except for 1 case with recurrence. Conclusions For decreasing operation risks, we should manipulate the inflow and outflow tract of hemangioma. It is necessary to resect the hemangioma entirely as possible as we can, pay attention to outflow tract and expose the hemangioma. In emergency case, gauze pressure is an advisable selection.