Journal of Chest Surgery

  • 제35권10호
  • /
  • Pages.755-759
  • /
  • 2002
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  • 2765-1606(pISSN)
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  • 2765-1614(eISSN)
대한심장혈관흉부외과학회 (The Korean Society for Thoracic and Cardiovascular Surgery)
권호 표지

심도 저체온 순환 정지를 이용한 하대정맥에 파급된 신세포암의 수술적 치료 -1례 보고-

Surgical Treatment of Renal Cell Carcinoma with IVC Tumor Extension Using Deep Hypothermic Circulatory Arrest - A Case Report -

  • 강신광 (충남대학교 의과대학 흉부외과학 교실) ;
  • 김시욱 (충남대학교 의과대학 흉부외과학 교실) ;
  • 원태희 (충남대학교 의과대학 흉부외과학 교실) ;
  • 구관우 (충남대학교 의과대학 흉부외과학 교실) ;
  • 나명훈 (충남대학교 의과대학 흉부외과학 교실) ;
  • 유재현 (충남대학교 의과대학 흉부외과학 교실) ;
  • 임승평 (충남대학교 의과대학 흉부외과학 교실) ;
  • 이영 (충남대학교 의과대학 흉부외과학 교실) ;
  • 설종구 (충남대학교 의과대학 비뇨기과학 교실)
  • Kang, Shin-Kwang (Dept. of Thoracic and Cardiovascular Surgery, College of Medicine, Chungnam National University) ;
  • Kim, Si-Wook (Dept. of Thoracic and Cardiovascular Surgery, College of Medicine, Chungnam National University) ;
  • Won, Tae-Hee (Dept. of Thoracic and Cardiovascular Surgery, College of Medicine, Chungnam National University) ;
  • Ku, Kwan-Woo (Dept. of Thoracic and Cardiovascular Surgery, College of Medicine, Chungnam National University) ;
  • Na, Myung-Hoon (Dept. of Thoracic and Cardiovascular Surgery, College of Medicine, Chungnam National University) ;
  • Yu, Jae-Hyun (Dept. of Thoracic and Cardiovascular Surgery, College of Medicine, Chungnam National University) ;
  • Lim, Seung-Pyung (Dept. of Thoracic and Cardiovascular Surgery, College of Medicine, Chungnam National University) ;
  • Lee, Young (Dept. of Thoracic and Cardiovascular Surgery, College of Medicine, Chungnam National University) ;
  • Sul, Jong-Goo (Dept. of Urology, College of Medicine, Chungnam National University)
  • 발행 : 2002.10.01
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초록

64세 남자가 혈뇨를 주소로 입원하여 하대정맥으로 종양 혈전이 파급된 우측 신세포암으로 진단받았다. 우신 적출술 시행 후 역행성 뇌관류하면서 심도 저체온 순환정지 하에 하대정맥 혈전 제거술을 시행하였다. 종양 혈전은 우 신에서 기원하여 하대정맥으로 자라면서 좌 신정맥의 생식선정맥 유입구까지, 위로는 간정맥 유입부까지, 아래로는 신정맥 하방 3cm까지 파급되어 있었다. 심도 저체온 순환 정지 하에서 하대정맥 손상 없이 혈전을 완전히 제거하였고 술 후 경과는 순조로웠다. 술 후 인터페론 면역 치료를 받았고 특별한 문제없이 추적관찰 중이다.

A 64-year-old man was admitted for gross hematuria. Preoperative study revealed right renal cell carcinoma with inferior vena cava(IVC) tumor thrombus. Right radical nephrectomy was performed, and deep hypothermic circulatory arrest(DHCA) with retrograde cerebral perfusion(RCP) was used for extraction of tumor thrombus in the IVC. The thrombus originated from the right kidney, which extended the orifice of the gonadal vein in the left renal vein laterally, the hepatic vein superiorly, and 3cm below the right renal vein inferiorly. The thrombus was removed completely without caval wall injury under DHCA with RCP, and the postoperative course was uneventful. He received immunotherapy with interferon, and followed up without any surgical problem.

키워드

참고문헌

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