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상간하대정맥부터 총장골정맥분지까지 연장된 하대정맥 평활근 육종의 체외절제 후 인공 하대정맥 재건 및 자가 간이식
문덕복(Deok-Bog Moon),이승규(Sung-Kyu Lee),김기훈(Ki-Hum Kim),안철수(Chul-Soo Ahn),하태용(Tae-Yong Ha),송기원(Gi-Won Song),정동환(Dong-Hwan Jung),유제호(Je-Ho Ryu),김관우(Kwan-Woo Kim),고경훈(Kyoung-Hoon Ko),최남규(Nam-Kyu Choi) 한국간담췌외과학회 2008 한국간담췌외과학회지 Vol.12 No.3
Ex situ resection and hepatic auto-transplantation as devised by Pichlmayr may be an answer for a lesion that has close proximity to or has invade the major hepatic veins. We report here on a 31-year-old female patient with a leiomyosarcoma extending from the suprahepatic vena cava to the bifurcation of the common iliac vein, and this tumor was deemed not accessible by the conventional in situ surgical techniques. The liver and retrohepatic inferior vena cava was removed en bloc and taken to the back-table where the neoplasm invading the cava wall was removed together with the inferior vena cava. The inferior vena cava was then replaced by a 26- mm Dacron graft proximally and a 20-mm ringed polytetrafluoroethylene (PTFE) graft distally, and the outflows of the liver was reconstructed to a single opening with using longitudinallyopened autogenous great saphenous vein fencing. The liver was then autotransplanted by the Piggyback technique. Both renal veins were not reconstructed because both gonadal veins were preserved during the operation. The postoperative course was uneventful and the patient is in good health until now.