摘要目的 总结TempofilterⅡ滤器在手术治疗肾癌合并腔静脉瘤栓中应用的经验.方法 回顾性分析2015年1月1日至2017年8月1日,在首都医科大学附属北京友谊医院手术治疗的肾癌伴有Ⅰ级或Ⅱ级瘤栓(Novick分级)并行肾癌根治术(腹腔镜下或开腹术下)的16例患者,且术前放置下腔静脉滤器.右肾癌11例,左肾癌5例.瘤栓分级Ⅰ级10例,Ⅱ级6例.结果 手术均获得成功,本组病例均为术后即刻取出滤器,术中血氧饱和度均保持稳定.单纯肾癌根治术6例,肾癌根治术+取瘤栓10例,其中下腔静脉直接缝合6例,下腔静脉人工补片3例,下腔静脉人工血管重建1例.结论 TempofilterⅡ滤器在手术治疗肾癌合并腔静脉瘤栓(Ⅰ级和Ⅱ级)中预防症状性肺栓塞是可靠的,且技术简便安全.

abstractsObjective To analysis and summarize the experience of surgical treatment of renal cancer complicated with inferior vena cava tumor thrombus with the aid of the Tempofilter Ⅱ filter. Methods The clinical data of 16 cases of renal cancer complicated with inferior vena cava level Ⅰ and Ⅱ tumor thrombus (Novick staging system), received surgical treatment with the aid of the Tempofilter Ⅱ filter, were retrospectively analyzed from January 1, 2015 to August 1, 2017. There were 11 cases of right renal cancer and 5 cases of left renal cancer. The level of inferior vena cava tumor thrombus was evaluated by Novick staging system, and ten patients were classified as level Ⅰ, 6 patients were classified as level Ⅱ. Results All operations were successful, and the filter was removed immediately after the surgery, and intraoperative the oxyhemoglobin saturation remained stable. There were 6 cases of radical nephrectomy, and ten cases of radical nephrectomy combined with thrombectomy of inferior vena cava (6 cases of the inferior vena cava suture, 3 cases of inferior vena cava artificial patch and 1 case of inferior vena cava artificial vascular reconstruction). Conclusion The application of Tempofilter Ⅱ filter in surgical treatment for renal cancer with inferior vena cava tumor thrombus (level Ⅰ and Ⅱ) is reliable, safe and convenient, in prevention of the symptomatic pulmonary embolism.