肾癌合并静脉瘤栓的外科治疗效果观察

目的 观察肾癌根治性切除加瘤栓取出术治疗肾癌合并静脉瘤栓的效果。方法 总结8例肾脏恶性肿瘤合并静脉瘤栓患者的临床及病理资料。男7例，女1例。平均年龄58岁。右侧7例，左侧1例。Robson分期Ⅲ期5例，Ⅳ期3例。瘤栓类型：肾静脉型1例，肝下型4例，肝上型3例。结果 7例患者行肾肿瘤根治性切除加瘤栓取出术，1例行右肾肿瘤及右肾上腺根治性切除术，腔静脉瘤栓放射治疗。1例瘤栓达右心房者术中死亡。随访7例，3例分别存活2、4和22个月，均死于远隔转移。4例术后已随访12、14、25和47个月者现仍无瘤存活。结论 肾肿瘤根治性切除加瘤栓取出术是治疗肾癌合并静脉瘤栓的有效方法。

Surgical therapy for tumor embolism of the inferior vena cava in renal cell carcinoma

Objective To observe the efficacy of radical nephrectomy plus embolectomy for the treatment of renal cell carcinoma with renal vein or inferior vena cava involvement. Methods Clinical and pathologic data of 8 patients with renal cell carcinoma extending into renal vein or inferior vena cava were summarized.The operative essentials were introduced,and survival periods were followed up. Results A total of 8 patients underwent radical nephrectomy plus embolectomy.One patient died during the operation after embolectomy with exhausted respiration and cardiovascular function.Three patients survived for 2,4 and 22 months respectively,but all died of distal metastasis later.Four patients were alive for 2,14,25 and 47 months respectively after operations till writing of this article. Conclusions Radical nephrectomy plus embolectomy is a valuable method for the treatment of renal cell carcinoma with renal vein or inferior vena cava involvement.