ОСОБЕННОСТИ ХИРУРГИЧЕСКОЙ ТАКТИКИ ЛЕЧЕНИЯ БОЛЬНЫХ С ПОЧЕЧНО-КЛЕТОЧНЫМ РАКОМ, ОСЛОЖНЁННЫМ ОПУХОЛЕВЫМ ТРОМБОЗОМ НИЖНЕЙ ПОЛОЙ ВЕНЫ

The postcava tumor thrombosis had about 1/3 of patients with renal cell carcinoma at the initial examination. Reconstructive interventions were performed on the postcava for 38 patients (24 men, 14 women). The postcava thrombectomy was applied in 15 patients. The thrombectomy with postcava resection were carried out in 13 patients and plasty- in 6, prosthetics-in 4. An actuarial 3-year or 5-year survival rate of patients consisted of 59,4% and 42,2%. The performance of reconstructive interventions on postcava with its involvement was justified and provided satisfactory results in patients with renal cell carcinoma.

почечно-клеточный рак, опухолевый тромбоз нижней полой вены, тромбэктомия, резекция, протезирование вены, renal cell carcinoma, postcava tumor thrombosis, thrombectomy, resection, postcava prosthetics

1. Давыдов М. И., Матвеев В. Б. Хирургическое лечение больных раком почки с опухолевым тромбозом почечной и нижней полой вен // Онкоурология. 2005. № 2. С. 8–15.

2. Матвеев В. Б. Хирургическое лечение осложнённого венозной инвазией и метастатического рака почки: Автореф. дис. … д-ра мед. наук. М., 2002. 35 с.

3. Матвеев Б. П. Клиническая онкоурология. М., 2003. С. 158–162.

4. Савельев В. С., Гологорский В. А., Кириенко А. И. и др. Флебология: Руководство для врачей / Под ред. В. С. Савельева. М: Медицина, 2001. 664 с.

5. Чиссов В. И., Старинский В. В., Петрова Г. В. Злокачественные новообразования в России в 2004 году. М., 2006.

6. Щукин Д. В., Илюхин Ю. А. Хирургия опухолевых тромбов нижней полой вены при раке почки. Белгород: ОАО «Белгородская областная типография», 2007. С. 47–48, 174–175.

7. Bensalah K., Guille F., De la Taille A.et al. Prognostic significance of inferior vena cava invasion in 764 T3b and T3c renal tumours // Eur. Urol. Suppl. 2005. Vol. 4. P. 52.

8. Blute M. L., Leibovich B. C., Lohse Ch.M. et al. The Mayo Clinic experience with surgical management, complications and outcome for patients with renal cell carcinoma and venous tumor thrombus // Br. J. Urol. Int 2004. Vol. 94. P. 33–41.

9. Chen H., Ng V., Kane Ch. et al. The role of transesophageal echo-cardiography in rapid diagnosis and treatment of migratory tumor embolus // Anesth. Analg. 2004. Vol. 99. P. 357–359.

10. Ciancio G., Vaidya A., Soloway M. Early ligation of the renal artery using the posterior approach: a basic surgical concept reinforced during resection of large hypervascular renal cell carcinoma with or without inferior vena cava thrombus // Br. J. Urol. Int. 2003. Vol. 92. P. 488–489.

11. Kobayashi T., Ogura K., Nishizawa K. et al. Successful recovery from a massive pulmonary artery tumor embolism occurring during surgery for renal cell carcinoma // Int. J. Urol. 2004. Vol. 11. P. 114–116.

12. Marshall F.F., Dietrick D. D., Baumgartner W.A., Reitz B. A. Surgical management of renal cell carcinoma with intracaval neoplastic extension above the hepatic veins // J. Urol. 1988. Vol. 139. P. 1166.

13. Nesbitt J. C., Soltero E. R., Dinney C. P.N. et al. Surgical management of renal cell carcinoma with inferior vena tumor thrombus // Ann. Thorac. Surg. 1997. Vol. 63. P. 1592–1600.

14. Rigaud J., Hetet J. F., Braud G. et al. Surgical care, morbidity, mortality and follow-up after nephrectomy for renal cancer with extention of tumor thrombus into inferior vena cava: retrospective study since 1990s // Eur. Urol. 2006. Vol. 50. P. 302–310.

15. Skinner D. G., Pritchett T. R., Lieskovsky G. et al. Vena caval involvement by renal cell carcinoma. Surgical resection provides meaningful long-team survival // Ann. Surg. 1989. Vol. 210. P. 387.

16. Staehler G., Brcovic D. The role of radical surgery for renal cell carcinoma with extension into the vena cava // J. Urol. 2000. Vol. 163. P. 1671–1675.

17. Zini L., Haulon S., Decoene Ch. et al. Renal cell carcinoma associated with tumor thrombus in the inferior vena cava: surgical strategies // Ann. Vasc. Surg. 2005. Vol. 10. P. 31–39.