| Japanese |
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| Title | Temporary IVC filterが抜去不能となった腎腫瘍の1症例 |
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| Subtitle | 症例 |
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| Authors | 硲光司*, 御村光子*, 山崎裕*, 岩崎富美*, 並木昭義** |
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| Organization | *滝川市立病院麻酔科, **札幌医科大学医学部麻酔学教室 |
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| Journal | 循環制御 |
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| Volume | 19 |
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| Number | 4 |
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| Page | 561-564 |
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| Year/Month | 1998/ |
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| Article | 報告 |
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| Publisher | 日本循環制御医学会 |
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| Abstract | 「要旨」腎静脈内に侵潤した左近腫瘍の根治的腎摘出術に際し, 術中肺塞栓防止のため挿入した一時的下大静脈フィルター(Temporary IVC filter, 以下IVC-f)が抜去不能となった症例を経験した. 症例は64歳男性, 既往歴は特になし. 近医で左腎腫瘍と診断され, 当院泌尿器科で手術が予定された. CTにて左腎静脈内に腫瘍侵潤が認められたが, 下大静脈(以下IVC)内への侵潤はないと考えられた. しかし手術操作により腫瘍塊または血栓による肺塞栓の危険があるため, IVC-fを挿入することとした. 手術前日にIVC-fを右内頸静脈から挿入した. IVC中枢側にすぐ肝尾状葉が接しており, IVCを頭側に十分剥離することが困難だったため, IVCに約4cmのside clampをかけ, IVC壁を含めて左腎静脈が切除された. 術中の呼吸循環動態には大きな変動はなかった. 手術終了後にIVC-f抜去を試みたが, 抵抗が大きく抜去できなかった. IVC造影の結果, 血管縫合部上縁にフィルター先端が固定されていることがわかった. |
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| Practice | 基礎医学・関連科学 |
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| Keywords | Temporary IVC filter, 術中肺塞栓, 麻酔管理 |
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| English |
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| Title | Failure in Removal of Temporary IVC filter: Report of a Case of Renal Tumor |
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| Authors | Kohji Hazama*, Mitsuko Mimura*, Yutaka Yamazaki*, Fumi Iwasaki*, Akiyoshi Namiki** |
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| Organization | *Department of Anesthesiology, Takikawa Municipal Hospital, **Department of Anesthesiology, Sapporo Medical University School of Medicine |
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| Journal | Circulation Control |
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| Volume | 19 |
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| Number | 4 |
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| Page | 561-564 |
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| Year/Month | 1998/ |
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| Article | Report |
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| Publisher | Japan Society of Circulation Control |
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| Abstract | A 64-year-old male with left renal tumor presented for radical nephrectomy. The renal tumor had infiltrated to the left renal vein, It was considered that the patient had a risk of intraoperative pulmonary embolism by isolated tumor fragments. Temporary IVC filter (AntheorTM, Boston Scientific) was inserted preoperatively. The filter basket was placed in the IVC, cephalad from the left renal vein, caudad from the hepatic vein. The tumor and the renal vein was resected, under side-clamping the IVC wall. The operation was finished without hemodynamic changes, but the IVC-filter could not be removed by simple traction. Angiography revealed the tip of the filter was fixed in the suture of the IVC wall. The filter was removed by re-laparotomy. Temporary IVC filter is very useful in preventing pulmonary embolism, however it is necessary to have close communication with the operator when we manage it during the operation. |
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| Practice | Basic medicine |
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| Keywords | Temporary IVC filter, Pulmonary embolism, Anesthetic management |
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