腹腔镜治疗肾错构瘤并肾静脉及下腔静脉瘤栓1例并文献复习

目的：探讨全腹腔镜治疗肾错构瘤并肾静脉及下腔静脉瘤栓的可行性分析。方法：回顾性分析1例腹腔镜治疗肾错构瘤并肾静脉及下腔静脉瘤栓患者的临床资料。患者，女，26岁，体检时发现右肾占位，B超示右肾窦内可见5．1cm×2．7cm高回声占位，边界欠规则，内见血流。CT示右肾盂旁可见一不规则团块状混杂密度影，大小为4．5cm×2．9cm×1．9cm，可见脂肪成分，最低密度-40HU；病变软组织部分明显强化，增强前后CT值分别为31HU和97HU，病变主要位于肾窦，部分延伸至肾静脉及腔静脉内。检索Pubmed和CBM数据库相关文献进行复习。结果：患者在全麻下行腹腔镜右肾切除及肾静脉、下腔静脉取栓术，瘤栓进入下腔静脉0．6cm。病理诊断右肾错构瘤。术后随访6个月无肿瘤复发和转移。结论：肾错构瘤并。肾静脉及下腔静脉瘤栓临床罕见，对选择性病例行腹腔镜肾切除并行肾静脉及下腔静脉取栓术安全可行。

Laparoscopic Nephrectomy and Thrombectomy for Renal Angiomyolipoma with Vena Caval and Renal Vein Thrombus(1 Case Report and Review of the Literature)

Objective：To evaluate the feasibility of laparoscopic nephrectomy and thromhectomy for renal angiomyolipoma with vena caval and renal vein thrombus. Methods： One case of renal angiomyolipoma with vena caval and renal vein thrombus was reported. The patient was a 26-year-old girl and the tumor was found incidentally. B- ultrasound showed 5.1 cm×2.7 cm large patches of high echo in the right kidney with blood flow signal. CT re vealed a solid mass of 4.5 cm×2.9 cm×1.9 cm in diameter in the right kidney with fat component, the lowest density was 40 HU; Soft tissue lesions significantly enhanced in part, the CT value were 31 HU and 97 HU be- fore and after enhancement. Thrombus was found in renal vein and vena cava. The Pubmed and CBM databases were searched for related articles,and the clinical data were reviewed. Results：The patient received laparoscopic ne phrectomy and thrombectomy with vena caval and renal vein thrombus under general anesthesia, tumor thrombus entered into the inferior vena cava 0 . 6 cm. The pathological diagnosis was renal angiomyolipoma. The patient was no tumor recurrence and metastasis in 6 months after operation. Conclusions.. Renal angiomyolipoma with vena caval and renal vein thrombus is rare, and taparoscopic nephrectomy and thrombectomy for renal angiomyolipoma with vena caval and renal vein thrombus is feasible in carefully selected patients.