侵犯下腔静脉的肝脏恶性肿瘤手术治疗

目的 探讨肝肿瘤侵犯下腔静脉的手术处理方法,以提高切除及手术安全性。方法 回顾性分析了1996年元月至2005年9月收治的29例肝脏恶性肿瘤侵犯下腔静脉手术切除的临床资料。包括肿瘤大小、位置、分期以及手术的方式和预后等。结果 29例侵犯下腔静脉的肝肿瘤的手术方式有下腔静脉部分切除、修补术共25例,肝癌切除并下腔静脉取癌栓4例,手术均成功,无手术并发症发生。结论 B型超声、CT、磁共振（MR／）是术前必不可少的检查,MR／可以明确下腔静脉受压、受侵、移位及有无闭塞等。侵犯下腔静脉肝肿瘤可选择性行根治性切除。下腔静脉壁部分切除、修补是安全、有效、可行的,可以大大提高肿瘤的切除率。

Surgical treatment of hepatic cancer invading inferior vena cava

Objective To explore the surgical manipulation off the inferior vena cava(IVC) in the hepatic cancer invading IVC in order to increase the resection rate and operative safety.Methods The clinical data of 29 cases of hepatic cancer invading IVC,25 males and 4 females,aged 42.45(4~60) who underwent resection of the tumor January 1996~September 2005 were analyzed retrospectively.Results(The operation) patterns related to the IVC included partial excision and repair of the IVC(in 25 cases) and resection of the tumor and withdrawal of the tumor thrombus(in 4 cases with tumor thrombus in IVC).All the operations were successful without operative death and major complications.Conclusion Radical resection can be used in selected patients with hepatic cancer invading IVC.Safe,effective,and practical,resection and reconstruction of IVC increases the excision rate of hepatic cancer remarkably.