细胞癌与"解"的瘤血栓:手术期间从III级转移到IV级
Marina Mata1,2,3, Marina M Tabbara1,2, Angel Alvarez2
1Department of Surgery, University of Miami Miller School of Medicine, Jackson Memorial Hospital, Miami, FL, USA.
World journal of surgical oncology
|March 8, 2024
概括
瘤血栓 (TT) 的细胞癌 (RCC) 的手术治疗可能是复杂的. 这一案例证明了在没有心肺绕道的情况下成功地进行腹部治疗的方法,用于广泛的TT,辅助的是手术内TEE监测.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 手术瘤学手术瘤学
- 心血管外科心血管外科
背景情况:
- 完整的外科切除是细胞癌 (RCC) 与瘤血栓 (TT) 的黄金标准.
- 延伸到下静脉 (IVC) 和右心房的大型TT会带来重大的手术挑战.
- 传统的方法通常需要心肺绕道 (CPB),但正在出现最少的侵入性技术.
研究的目的:
- 展示一个复杂的RCC与TT的案例,在没有CPB的情况下成功管理.
- 为了突出手术内转食管心声学 (TEE) 在管理意想不到的TT延长中的实用性.
- 强调多学科外科手术方法的重要性.
主要方法:
- 描述了一个带TT水平IIIc的RCC病例.
- 在手术期间,TT意外扩展到右心房 (IV级).
- 复杂的瘤血栓通过一种没有CPB的腹部方法来管理,利用手术内TEE和备用心胸支持.
主要成果:
- 通过广泛的TT实现了RCC的成功外科切除.
- 该程序仅通过腹部方法完成,避免CPB.
- 在手术期间的TEE监测有效地指导了手术策略,以应对不断变化的TT延伸.
结论:
- 至少侵入性的外科技术可以有效的复杂的RCC与TT.
- 持续的手术内TEE监测对于实时评估TT程度至关重要.
- 跨学科的团队方法对于管理具有挑战性的案件和避免并发症至关重要.
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