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目的:探讨全腹腔镜治疗肾错构瘤并肾静脉及下腔静脉瘤栓的可行性分析。方法:回顾性分析1例腹腔镜治疗肾错构瘤并肾静脉及下腔静脉瘤栓患者的临床资料。患者,女,26岁,体检时发现右肾占位,B超示右肾窦内可见5.1 cm×2.7 cm高回声占位,边界欠规则,内见血流。CT示右肾盂旁可见一不规则团块状混杂密度影,大小为4.5 cm×2.9 cm×1.9 cm,可见脂肪成分,最低密度—40 HU;病变软组织部分明显强化,增强前后CT值分别为31 HU和97 HU,病变主要位于肾窦,部分延伸至肾静脉及腔静脉内。检索Pubmed和CBM数据库相关文献进行复习。结果:患者在全麻下行腹腔镜右肾切除及肾静脉、下腔静脉取栓术,瘤栓进入下腔静脉0.6 cm。病理诊断右肾错构瘤。术后随访6个月无肿瘤复发和转移。结论:肾错构瘤并肾静脉及下腔静脉瘤栓临床罕见,对选择性病例行腹腔镜肾切除并行肾静脉及下腔静脉取栓术安全可行。
Objective: To investigate the feasibility of total laparoscopic treatment of renal hamartoma with renal vein and inferior vena cava tumor suppository. Methods: A retrospective analysis of 1 case of laparoscopic treatment of renal hamartoma with renal vein and inferior vena cava tumor thrombus in patients with clinical data. Patients, female, 26 years old, physical examination found right kidney occupancy, B ultrasound showed that the right renal sinus 5.1 cm × 2.7 cm high echogenic place, border rules, see the blood flow. CT showed an irregular mass of mixed renal pelvis density shadow, the size of 4.5 cm × 2.9 cm × 1.9 cm, showing fat composition, the lowest density of -40 HU; part of the lesion was significantly enhanced, enhanced before and after CT values were 31 HU And 97 HU, the lesion is mainly located in the renal sinus, part of the extension to the renal vein and vena cava. Retrieve Pubmed and CBM database related literature for review. Results: Under general anesthesia, the patients underwent laparoscopic right nephrectomy and renal vein and inferior vena cava thrombectomy. The tumor plug entered the inferior vena cava 0.6 cm. Pathological diagnosis of right renal hamartoma. All patients were followed up for 6 months without tumor recurrence and metastasis. Conclusion: Renal hamartoma and renal vein and inferior vena cava tumor thrombus are rare. It is safe and feasible to perform laparoscopic nephrectomy in parallel with renal vein and inferior vena cava in selective cases.