共查询到20条相似文献,搜索用时 10 毫秒
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目的 探讨原发性下腔静脉平滑肌肉瘤的临床特点和诊治方法.方法 回顾性分析2006年6月至2009年4月收治的7例原发性下腔静脉平滑肌肉瘤的临床资料,包括临床表现、手术方法、病理结果和预后.结果 3例完整切除肿瘤,其中2例下腔静脉管壁缺损应用人工血管进行修补;1例切除部分肿瘤,恢复肝静脉血流;3例行剖腹探查肿瘤活检,明确诊断后放弃手术.7例术后病理均为原发性下腔静脉平滑肌肉瘤,3例雌激素受体(estrogen receptor,ER)、孕激素受体(progesterone receptor,PR)呈阳性,4例呈阴性.无围手术期死亡病例,3例完整切除肿瘤者术后预防性口服华法林抗凝6个月,分别随访8、32、33个月,未发现肿瘤复发和血栓形成;1例部分切除者存活2个月,死于肝功能衰竭;3例只行肿瘤活检者均于7个月内死亡.结论 完整切除肿瘤和必要的下腔静脉重建是治疗原发性下腔静脉平滑肌肉瘤的惟一有效方法. 相似文献
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《Urologic oncology》2022,40(3):110.e11-110.e18
ObjectivesTo compare the surgical and oncological outcomes of older patients undergoing surgery for renal cell carcinoma (RCC) with a tumor in the inferior vena cava (IVC) and those of younger patients.Materials and methodsWe retrospectively evaluated 123 patients who underwent surgery for RCC-IVC at two institutions between 2008 and 2019. We classified them into the ≥70 years and the <70 years group, based on their age during surgery. The patients’ perioperative outcomes as well as survival (overall survival [OS] and cancer-specific survival [CSS]) were evaluated and compared before and after 1:1 propensity score matching. Sensitivity analyses were performed at age thresholds of 75 and 80 years.ResultsThe ≥70 and the <70 groups comprised 43 and 80 patients, respectively. Most patients in the ≥70 group demonstrated an American Society of Anesthesiologists score of 2 or 3. They were more likely to have a statistically insignificant high (≥3) Charlson Comorbidity index score (16.3 vs. 6.3%) and a lower hemoglobin level (10.4 vs. 11.7 g/dL) than the <70 group. Eighteen (41.9%) and 32 (40.0%) patients had at least one distant metastasis at the time of surgery in the ≥70 and <70 group, respectively. The complication rates (any grade and grade ≥3), the length of hospitalization, readmission rates, and mortality were comparable between the groups, both before and after matching (all, non-specific). There was no statistically significant difference in the OS (median 66.6 vs. not reached [N.R.], P = 0.695) or CSS (N.R. vs. N.R., P = 0.605) between the groups before matching. The OS and CSS results were similar and comparable following matching (both, non-specific). Further, OS and CSS were comparable between the ≥75 and <75 groups, and between the ≥80 and <80 age groups, respectively.ConclusionThe surgical outcomes of older patients with RCC-IVC were not inferior to those of younger patients. With careful patient selection, surgery can still be a treatment option. 相似文献
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Surgical treatment of retroperitoneal leiomyosarcoma invading the inferior vena cava: report of three cases 总被引:4,自引:0,他引:4
Shindo S Matsumoto H Ogata K Katahira S Kojima A Iyori K Ishimoto T Kobayashi M Tada Y Suzuki T Itakura J Iizuka H Matsumoto Y 《Surgery today》2002,32(10):929-933
Retroperitoneal leiomyosarcoma is a rare neoplasm for which complete surgical removal provides the only effective treatment,
as local recurrence adversely affects prognosis. However, invasion of major vessels may occur, making complete resection difficult.
This report describes the cases of three patients who required concomitant resection of parts of the inferior vena cava because
of direct tumor invasion. The major vessels should be isolated in preference to the tumor capsule during surgery to prevent
sudden exsanguination or incomplete tumor resection. Resection of a recurrent sarcoma or a solitary metastasis can be effective
in selected patients.
Received: September 20, 2001 / Accepted: May 7, 2002 相似文献
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G Bajardi G Ricevuto N Grassi G Giuntini P Romano M Latteri 《Minerva chirurgica》1989,44(7):1103-1106
Personal experience of thromboses of the inferior vena cava is presented and pathogenetic and symptomatological aspects stressed. In addition, in relation to the results presented and reported data, it is concluded that the role of surgical therapy is fundamental to integrate the thrombolytic and anticoagulant treatment of these severe forms of deep venous thrombosis. 相似文献
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累及下腔静脉的腹膜后肿瘤手术处理经验 总被引:7,自引:0,他引:7
目的探讨累及下腔静脉的腹膜后肿瘤手术时下腔静脉的处理方法 ,以提高切除率及手术安全性。方法回顾性分析 1990年 1月至 2 0 0 3年 4月收治的 4 1例腹膜后肿瘤累及下腔静脉的手术切除及血管重建的临床资料。结果 4 1例累及下腔静脉的腹膜后肿瘤的手术方式有 :下腔静脉部分切除、修补术 17例 ;部分下腔静脉并右肾切除术 11例 ;部分下腔静脉切除、残端结扎术 10例 ,其中 3例行人工血管植入术。结论B超、CT、MRI是术前必不可少的检查 ,选择性血管造影可以明确下腔静脉受压、移位、畸形及有无闭塞。累及下腔静脉并非腹膜后肿瘤行根治性切除的手术禁忌证 ,下腔静脉部分切除与重建安全、有效、可行 ,可以大大提高肿瘤的切除率、降低复发率。 相似文献
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Leiomyosarcoma of primary vascular origin is a rare primary soft tissue tumour, which arises mainly from the inferior vena cava (IVC). Clinical symptoms depend upon the size and location of the tumour and presents usually with abdominal pain, palpable mass and weight loss. Complete surgical resection with clear surgical margin plays a central therapeutic role. The effect of chemotherapy and radiation therapy remains to be evaluated. We report a 64 year old Chinese female who presented with abdominal mass and pain associated with weight loss and was subsequently diagnosed with inferior vena cava leiomyosarcoma. She underwent successful surgical resection but unfortunately developed recurrence of tumour 12 month post-operative. She was also found to have a duplicated inferior vena cave which allowed reconstitution of venous return from the lower limbs after surgical resection of the IVC tumour. We discuss the surgical treatment and results of leiomyosarcoma of the IVC. 相似文献
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M Nagayoshi K Umetsu E Tanae S Nishihara K Ishibashi N Ninomura M Goto K Mori M Akagi 《Kyobu geka. The Japanese journal of thoracic surgery》1989,42(2):155-159
Primary leiomyosarcoma of the inferior vena cava is rare and fatal. A 15-year-old female was admitted with the diagnosis of the right atrial myxoma associated with the Budd-Chiari syndrome. The tumor of the IVC was unresectable, although the right atrial tumor extended from the IVC was extirpated. Pathological examination of the tumor revealed a leiomyosarcoma. She was hemodynamically improved immediately after the operation. But she was expired due to the hepatic failure 9 days postoperatively. No autopsy was obtained. The literature regarding with leiomyosarcoma of the IVC was briefly reviewed. 相似文献
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K Gohji M Sugimoto G Hamami S Kamidono J Ishigami S Maeda T Sugiyama 《Hinyokika kiyo. Acta urologica Japonica》1985,31(5):813-819
A case of primary leiomyosarcoma of the inferior vena cava was reported. The patient, a 74-year-old man, consulted our hospital with complaints of back pain and abdominal mass in right flank. Probe laparotomy revealed a tumor situated in the retroperitoneum and multiple metastatic nodules in the liver. Biopsy was performed and diagnosed as leiomyosarcoma. He was intensively treated with antineoplastic chemotherapy, but his condition gradually aggravated. He died 4 months after admission. The autopsy revealed a right retroperitoneal mass (17 X 12 X 18 cm in size, 1,340 g in weight) that showed a yellowish appearance. There was also a thumb-tip sized tumor with a stalk in the lumen of inferior vena cava. Both tumors grew in continuity with each other through the wall of inferior vena cava. The tumors were diagnosed as leiomyosarcoma, which derived from inferior vena cava. 相似文献
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<正>患者女,55岁,因"无明显诱因出现腹部包块2年余"入院。查体:下腹部触及约15cm×15cm×20cm肿物,活动性欠佳,无明显压痛、反跳痛及肌紧张。CT:右侧腹膜后见团块状浅分叶型软组织密度影,约18.1cm×10.4cm×8.6cm,CT值约9~70HU,边缘尚清,增强扫描病灶呈不均匀延迟强化,内见 相似文献
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Bysani Chandrashekar Sathya Narayan Azeez Pasha Uliargoli Vasudeva Rao Nuggaehalley Krishna Bhagavan 《Indian Journal of Thoracic and Cardiovascular Surgery》2008,24(4):261-263
An intramural venous leiomyosarcoma is a rare, malignant tumour arising from the smooth muscle cells of the vessel wall and
the inferior vena cava (IVC) is the most common location. The middle part of IVC is most often affected, often involving the
kidneys. There is a strong prediction for women. Clinical symptoms depend upon the size and location of the tumour. Diagnosis
is often not made until advanced stage, as the symptoms are non-specific and they present late in the disease course. 相似文献
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