微创时代下腔静脉开放手术的治疗机遇

因下腔静脉在解剖学及组织学方面的特性,治疗上具有特殊性。本文通过回顾既往文献报道,对下腔静脉综合征、平滑肌肉瘤及布加综合征等下腔静脉疾病外科治疗方式的进展进行论述。下腔静脉综合征为下腔静脉部分或完全阻塞所致的临床症候群,较常见且病因多样,占位性病变中下腔静脉平滑肌肉瘤发病罕见,根治性切除是目前唯一有效的治疗手段,其中下腔静脉及肾静脉的处理为手术难点。布加综合征表现为肝后性门脉高压,外科治疗包括手术治疗及介入治疗。

Challenge of Surgical Treatment of Inferior Vena Cava in Minimally Invasive Era

Specific methods should be applied in treatment of lesions located in the inferior vena cava due to its characteristics in anatomy and histology.This article is focused on the historical and current surgical treatments for the inferior vena cava diseases such as inferior vena cava syndrome,leiomyosarcoma and Budd-Chiari syndrome.Inferior vena cava syndrome is a result of obstruction in inferior vena cava due to a variety of causes.Among them,primary leiomyosarcoma of occupying lesion occurs rarely and the only efficient therapy is radical surgical en bloc resection,and reconstruction of the inferior vena cava and involved renal veins remains controversial and challengeable.Budd-Chiari syndrome is caused by the obstruction of retrohepatic inferior vena cava and/or hepatic vein.Surgical treatments include open surgery and interventional therapy.