腎癌に対する拡大根治手術 : 胸腹式アプローチおよび肝の剥離によって摘除しえた下大静脈内腫瘍血栓の1例

Abstract

A case of successful removal of right renal cell carcinoma extending into inferior vena cava in a 62-year-old man was reported. The tumor thrombus reached the level of the liver and almost completely obliterated both caval and contralateral renal veins. With cooperation of cardiovascular and hepatic surgeons, the operation was performed under thoracoabdominal exposure. Extensive mobilization of the liver enabled us to regulate vena caval and hepatic blood circulation. The tumor thrombus, though partly adhesive to the caval vein, could be completely removed safely through a long cavotomy incision. To cope with the recent advance in more aggressive cancer surgery, it seems mandatory for urologists to acquire a broad knowledge of thoracic, cardiovascular and hepatic surgery as well.