Technical considerations for radical resection of a primary leiomyosarcoma of the vena cava.
HPB (Oxford)
; 14(8): 565-8, 2012 Aug.
Article
em En
| MEDLINE
| ID: mdl-22762406
ABSTRACT
BACKGROUND:
Radical resection provides the best hope for cure in leiomyosarcoma of the inferior vena cava (IVC). Multi-visceral resection is often indicated by extensive tumour involvement. This report describes the technical challenges encountered during resection of a retrohepatic IVC leiomyosarcoma.METHODS:
Computed tomography showed an IVC leiomyosarcoma measuring 7.8 × 10.0 × 19.3 cm in a 41-year-old patient. The tumour reached the confluence of the hepatic veins, displacing the caudate lobe anteriorly and extending towards the IVC bifurcation inferiorly. En bloc resection of the IVC tumour with a right hepatic and caudate lobectomy, and a right nephrectomy was performed.RESULTS:
Subsequent to a Cattel manoeuvre, the operative procedures carried out can be broadly categorized in four majorsteps:
(i) mobilization of the infrahepatic IVC and tumour; (ii) mobilization of the suprahepatic IVC from diaphragmatic attachments; (iii) right hepatectomy with complete caudate lobe resection, and (iv) en bloc resection of the IVC tumour. This approach allowed the entire length of tumour-bearing IVC to be freed from the retroperitoneum and avoided the risk for iatrogenic tumour rupture during dissection at the retrohepatic IVC. Reconstruction of the IVC was not performed in the presence of venous collaterals.CONCLUSIONS:
Experience in liver resection and transplantation, and appreciation of the hepatocaval anatomy facilitate the safe and radical resection of retrohepatic IVC leiomyosarcoma.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Procedimentos Cirúrgicos Vasculares
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Veia Cava Inferior
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Neoplasias Vasculares
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Hepatectomia
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Leiomiossarcoma
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Nefrectomia
Limite:
Adult
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Female
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Humans
Idioma:
En
Ano de publicação:
2012
Tipo de documento:
Article