侵及大血管的腹部肿瘤9例术式分析

目的 探讨腹部肿瘤与受侵大血管一同切除手术的临床应用价值。方法 回顾性分析1998年9月至2004年6月联合受侵大血管切除的腹部肿瘤根治术9例病人的临床资料。结果 9例腹部肿瘤病人均得到根治性切除。其中下腔静脉中段切除重建3例，肝静脉以下下腔静脉全部切除重建3例，下腔静脉部分切除结扎术1例，肿瘤剥脱保存肾脏和下腔静脉1例，下腔静脉与腹主动脉联合切除1例。无围手术期死亡。术后随访中1例病人18个月后死于肺转移，其余均长期生存。结论 联合切除腹部肿瘤和受侵大血管能够提高远期存活率。

Surgical treatment for abdominal tumors involving major vessels

Objective To explore the clinical application of abdominal tumor resection combined with major angiectomy. Methods The clinical data of 9 patients performed abdominal tumor resection combined with major angiectomy between September 1998 and June 2004 were analyzed retrospectively. Results Nine patients with abdominal tumors involving major vessels were performed curative resection,which was confirmed by postoperative pathohistological examination. Resection of middle-party IVC was performed in 3 patients, resection of IVC distal to hepatic vein in 3 patients, partial IVC resection 1 patient, tumor denudation from the wall of renal vein and IVC in 1 patient, and combined IVC and AAA resection in 1 patient. Circulation reconstruction was applied after angiectomy in all the cases. No perioperative death or major complications occurred in the group. Follow-up study revealed long-term survival in 8 patients. One patient died of pulmonary metastasis in the 18 months after operation. Conclusion Combined abdominal tumor resection and infiltrated major vessels can improve long-term survival significantly.