Intrapericardial isolation of the inferior vena cava through a transdiaphragmatic pericardial window for tumor resection without sternotomy or thoracotomy.
Eur J Surg Oncol
; 33(2): 239-42, 2007 Mar.
Article
em En
| MEDLINE
| ID: mdl-17174512
ABSTRACT
AIMS:
The prognosis for patients with advanced tumors invading the inferior vena cava (IVC) is dismal and surgical treatments for these tumors are challenging. A surgical approach that avoids sternotomy and thoracotomy for tumors invading the IVC even to the level of the hepatocaval junction would be extremely helpful.METHODS:
The intrapericardial IVC was isolated via a transdiaphragmatic pericardial window using a transabdominal approach. Hepatectomy was then applied via an anterior approach until the IVC was seen. Total hepatic vascular exclusion was achieved by clamping the portal triad, intrapericardial IVC and infrahepatic IVC. We removed the primary tumor, the liver portion involved and the tumor thrombi, with segmental resection of the IVC. Vascular continuity was reestablished using a 20-mm-diameter polytetrafluoroethylene graft.RESULTS:
Four patients with tumors invading the IVC were treated with this method. All underwent gross en-bloc tumor resections and all survived.CONCLUSION:
This method for the resection of IVC tumors could avoid emboli dislodging from the tumor thrombi, prevent the complications of sternotomy, cardiopulmonary bypass and shorten operative times.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Pericárdio
/
Procedimentos Cirúrgicos Vasculares
/
Veia Cava Inferior
/
Neoplasias do Córtex Suprarrenal
/
Leiomiossarcoma
/
Neoplasias Hepáticas
Tipo de estudo:
Diagnostic_studies
Limite:
Humans
Idioma:
En
Revista:
Eur J Surg Oncol
Assunto da revista:
NEOPLASIAS
Ano de publicação:
2007
Tipo de documento:
Article