초록접수 현황
| 14F-081 | 포스터 발표 |
Percutaneous Veno-venous Bypass use for Resection of Renal Cell Carcinoma Invading Inferior Vena Cava
Seunghwan Song1, Sung Woon Chung1, Sang-pil Kim1, Chung Won Lee1, Mi Ju Bae1, Tae Nam Kim2
1Department of Thoracic and Cardiovascular Surgery, 2Department of Urology, Pusan National University School of Medicine, Medical Research Institute, Pusan National University Hospital
Background : Complete resection of Renal Cell Carcinoma(RCCA) which extends through the Inferior vena cava(IVC) is important to increase the long term survival rate. Main concerns of operative technique are the extent of incision for complete resection, the prevention of embolic event, and the maintenance of venous drainage from lower body for stable hemodynamic status. According to the grade of involvement, various surgical techniques has been performed with or without extracorporeal bypass.
Methods : 56-years-old male patient admitted for an incidental right kidney mass. On abdominal and chest CT scan shows right renal mass involving IVC and pulmonary thromboembolism on a few segmental arteries. To prevent the progression of embolism, IVC filter was inserted immediately and elective surgery was planned. Upper median abdominal incision was done. Percutaneous veno-venous bypass from the right femoral vein to the right internal jugular vein was performed when IVC clamped. The mass and the right kidney were resected completely with inspection of inside of IVC and which was repaired with bovine pericardial patch. The bypass was weaned off soon after IVC repair. The bypass time was 50 minutes.
Results : The patient recovered without any complication and discharged the 9th postoperative day. Follow-up CT scan at 12 months after surgery shows no stenosis on IVC and no evidence of embolism and recurrence of tumor.
Conclusion : Percutaneous veno-venous bypass use can be a safe and simple method to prevent intraoperative hemodynamic instability for the patient with RCCA involving IVC below the grade II.
Methods : 56-years-old male patient admitted for an incidental right kidney mass. On abdominal and chest CT scan shows right renal mass involving IVC and pulmonary thromboembolism on a few segmental arteries. To prevent the progression of embolism, IVC filter was inserted immediately and elective surgery was planned. Upper median abdominal incision was done. Percutaneous veno-venous bypass from the right femoral vein to the right internal jugular vein was performed when IVC clamped. The mass and the right kidney were resected completely with inspection of inside of IVC and which was repaired with bovine pericardial patch. The bypass was weaned off soon after IVC repair. The bypass time was 50 minutes.
Results : The patient recovered without any complication and discharged the 9th postoperative day. Follow-up CT scan at 12 months after surgery shows no stenosis on IVC and no evidence of embolism and recurrence of tumor.
Conclusion : Percutaneous veno-venous bypass use can be a safe and simple method to prevent intraoperative hemodynamic instability for the patient with RCCA involving IVC below the grade II.
첨부파일 : 사진.pptx
책임저자: Seunghwan Song
Department of Thoracic and Cardiovascular Surgery, Pusan National University School of Medicine, Medical Research Institute, Pusan National University Hospital
연락처 : Seunghwan Song, Tel: 051-240-7267 , E-mail : song77.sh@gmail.com
