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目的探讨肾细胞癌并下腔静脉癌栓的手术治疗方法。方法回顾性分析6例经手术及病理证实的肾细胞癌并肝下型下腔静脉癌栓患者的临床资料,所有病例均行根治性肾切除并癌栓切除术,分别采用下腔静脉切开、下腔静脉部分切除和节段性下腔静脉切除三种方法取出癌栓。结果 6例手术均获成功,无大出血、肺梗塞等并发症,术后患者恢复良好。其中2例分别于术后38个月和76个月死亡,3例仍健在,平均存活时间为54个月,1例术后18个月后失访。结论右肾癌并下腔静脉癌栓患者下腔静脉节段性切除能够安全地进行,根治性肾切除并癌栓切除术能够使患者获得长期存活。
Objective To investigate the surgical treatment of renal cell carcinoma with inferior vena cava tumor thrombus. Methods The clinical data of 6 patients with renal cell carcinoma and subhepatic inferior vena cava tumor thrombus confirmed by surgery and pathology were retrospectively analyzed. All cases underwent radical nephrectomy and thrombectomy. , Part of the inferior vena cava resection and segmental resection of the inferior vena cava removed three methods of cancer embolus. Results All the 6 surgeries were successful. No complications such as hemorrhage and pulmonary infarction were found, and postoperative patients recovered well. Two of them died at 38 months and 76 months respectively. Three cases were still alive. The average survival time was 54 months. One case was lost after 18 months. Conclusions Segmental resection of inferior vena cava in patients with right renal cell carcinoma and vena cava tumor thrombus can be performed safely. Radical nephrectomy and thrombectomy can prolong the survival of patients.