Radical surgery for XXXX through exposure of the entire inferior vena cava of the hepatic segment.

@entity1 @entity5 @entity177 @entity3181 @entity6323 @entity715
BACKGROUND: Several kinds of radical surgery for the treatment of @entity3181 ( @entity3181 ) have been devised. We have described preliminary efforts to treat @entity3181 using a novel radical resection technique to expose the entire inferior vena cava (IVC) of the hepatic segment. METHODS: Sixty @entity1 with @entity3181 were treated by radical resection, including 46 @entity1 and 14 @entity1 . @entity3181 @entity1 ranged in age from 11 to 62 years, with 3 months to 11 years since the @entity3181 diagnosis. The lesions included membrane occlusion of the IVC in 16 @entity1 , double membranes within the IVC in 2 @entity1 , double membranes within the IVC and the hepatic vein (HV) in 3 @entity1 , IVC membrane with distal @entity715 in 10 @entity1 , long segment @entity715 of the IVC in 5 @entity1 (organized @entity715 in 2 @entity1 , fresh @entity715 in 3 @entity1 ), occlusion of the outlet of the HVs due to mural @entity715 in 2 @entity1 , segmental occlusion of the IVC in 3 @entity1 , membranes within the HV with @entity6323 due to protrusion of HV stent in 1 @entity1 , HV membranes in 11 @entity1 , extensive occlusion of HVs in 1 @entity1 , the whole IVC @entity5 thrombus with @entity5 thrombus of 2/3 right atrium resulting from a posterior peritoneum @entity5 in 1 @entity1 , @entity6323 in 2 @entity1 , @entity6323 with @entity5 thrombus into 1/2 right atrium in 1 @entity1 , IVC @entity715 extending into right atrium in 1 @entity1 , compression of supra-hepatic segment of IVC due to fiber trabs in 1 @entity1 . RESULTS: All lesions were successfully resected under direct supervision. Three procedures were performed under extracorporeal circulation, 52 @entity1 with catheterization of the right atrium, 4 @entity1 with a cell saver, and one @entity1 with auto-retrieval of blood. The retrieved blood was from 300 ml to 4000 ml. Transfusion of banked blood was from 400 ml to 2000 ml for 14 @entity1 . For the other @entity1 no transfusion of banked blood was required. One @entity1 died of @entity177 peri-operatively. Newly formed IVC membrane was found for one recurrent @entity1 whose IVC @entity715 was removed one year prior. Restenosis of the IVC was observed post-operatively without symptoms in one @entity1 . In the other @entity1 , no recurrent symptom was found during the follow-up periods. CONCLUSION: This novel surgery provides a clear visual field during the procedure and yields satisfactory short and long-term results.
