上大静脈および腕頭静脈合併切除を施行した胸部悪性腫瘍症例における血行再建術式と周術期管理の検討
目的：呼吸器外科手術において上大静脈や腕頭静脈の合併切除と血行再建を行った症例について，手術方法，周術期管理および再建血管の開存性について検討した．方法：2005年から2014年までに上大静脈および腕頭静脈の切除と再建を施行した15例を対象とした．患者背景，再建術式，使用した人工血管の種類，抗凝固療法および再建血管の閉塞の有無および閉塞時の症状等を調査した．結果：対象疾患は胸腺上皮性腫瘍11例，胚細胞性腫瘍2例，肺癌・悪性リンパ腫各1例で，切除した血管は上大静脈13例，右腕頭静脈12例，左腕頭静脈14例であった．全例で，血行再建には径10 mm以上の人工血管が使用され，周術期に抗凝固療法が行わ...
Saved in:
| Published in | 日本呼吸器外科学会雑誌 Vol. 31; no. 4; pp. 446 - 452 |
|---|---|
| Main Authors | , , , , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
特定非営利活動法人 日本呼吸器外科学会
2017
|
| Subjects | |
| Online Access | Get full text |
| ISSN | 0919-0945 1881-4158 |
| DOI | 10.2995/jacsurg.31.446 |
Cover
Loading…
| Abstract | 目的：呼吸器外科手術において上大静脈や腕頭静脈の合併切除と血行再建を行った症例について，手術方法，周術期管理および再建血管の開存性について検討した．方法：2005年から2014年までに上大静脈および腕頭静脈の切除と再建を施行した15例を対象とした．患者背景，再建術式，使用した人工血管の種類，抗凝固療法および再建血管の閉塞の有無および閉塞時の症状等を調査した．結果：対象疾患は胸腺上皮性腫瘍11例，胚細胞性腫瘍2例，肺癌・悪性リンパ腫各1例で，切除した血管は上大静脈13例，右腕頭静脈12例，左腕頭静脈14例であった．全例で，血行再建には径10 mm以上の人工血管が使用され，周術期に抗凝固療法が行われていた．再建血管の閉塞が確認されたのは6例で，左右腕頭静脈再建例では人工血管閉塞時の症状出現が少なかった．結論：大血管の切除を伴う手術は現在においても困難な術式であるが，今回検討した症例では周術期死亡や術後急性期の人工血管閉塞は認められなかった．また，人工血管閉塞に伴う症状が出現しない場合には血管閉塞時にも経過観察が可能であると考えられた． |
|---|---|
| AbstractList | 目的：呼吸器外科手術において上大静脈や腕頭静脈の合併切除と血行再建を行った症例について，手術方法，周術期管理および再建血管の開存性について検討した．方法：2005年から2014年までに上大静脈および腕頭静脈の切除と再建を施行した15例を対象とした．患者背景，再建術式，使用した人工血管の種類，抗凝固療法および再建血管の閉塞の有無および閉塞時の症状等を調査した．結果：対象疾患は胸腺上皮性腫瘍11例，胚細胞性腫瘍2例，肺癌・悪性リンパ腫各1例で，切除した血管は上大静脈13例，右腕頭静脈12例，左腕頭静脈14例であった．全例で，血行再建には径10 mm以上の人工血管が使用され，周術期に抗凝固療法が行われていた．再建血管の閉塞が確認されたのは6例で，左右腕頭静脈再建例では人工血管閉塞時の症状出現が少なかった．結論：大血管の切除を伴う手術は現在においても困難な術式であるが，今回検討した症例では周術期死亡や術後急性期の人工血管閉塞は認められなかった．また，人工血管閉塞に伴う症状が出現しない場合には血管閉塞時にも経過観察が可能であると考えられた． |
| Author | 重光, 希公生 上野, 陽史 福本, 紘一 森, 正一 内山, 美佳 横井, 香平 門松, 由佳 吉岡, 洋 |
| Author_xml | – sequence: 1 fullname: 上野, 陽史 organization: 名古屋第一赤十字病院呼吸器外科 – sequence: 1 fullname: 横井, 香平 organization: 名古屋大学呼吸器外科 – sequence: 1 fullname: 吉岡, 洋 organization: 名古屋第二赤十字病院呼吸器外科 – sequence: 1 fullname: 福本, 紘一 organization: 名古屋大学呼吸器外科 – sequence: 1 fullname: 重光, 希公生 organization: 大垣市民病院呼吸器外科 – sequence: 1 fullname: 内山, 美佳 organization: 小牧市民病院呼吸器外科 – sequence: 1 fullname: 門松, 由佳 organization: 名古屋第一赤十字病院呼吸器外科 – sequence: 1 fullname: 森, 正一 organization: 名古屋第一赤十字病院呼吸器外科 |
| BookMark | eNo9UE1LAlEAfERBVl77F2vvaz_eMaIvCLrUeXnqrilmsWuHbq1WSmVpURYUJQhJkpcIpLI_89x191-0pXSZGWaGOcwUGM_t5AwAZhGMYcbkuQxP2HtWKkZQjFJlDESQpiGJIlkbBxHIEJMgo_IkiNp2Og4hxphoRImASr974jafg4c7_7AsnBNRCPHNP7oOnl6Hplst93vvbrkU3DVF4dK76fmNM-HUhfPoF7tBseUVXryDZ_-oPbitDOql_vepcNq_U05NFE79xkHYd48r7ueH37hyvy6E03JrrVB794-DTmNQPRZOx2ve-63zGTBh8qxtREc8DTaXFjcWVqS19eXVhfk1KYMpg5KqItXUoGIkZapyU-FY5QlTjhPDhAphSZykkFCGNWJySE0TGiphGMtEgSjJESHTYH64m7HzPGXou1Z6m1v7Orfy6UTW0Edv6gTp9A-o8p8ltrgVFsgP0GGkFA |
| ContentType | Journal Article |
| Copyright | 2017 特定非営利活動法人 日本呼吸器外科学会 |
| Copyright_xml | – notice: 2017 特定非営利活動法人 日本呼吸器外科学会 |
| DOI | 10.2995/jacsurg.31.446 |
| DatabaseTitleList | |
| DeliveryMethod | fulltext_linktorsrc |
| EISSN | 1881-4158 |
| EndPage | 452 |
| ExternalDocumentID | article_jacsurg_31_4_31_446_article_char_ja |
| GroupedDBID | ABJNI ACGFS ALMA_UNASSIGNED_HOLDINGS JSF KQ8 OK1 RJT |
| ID | FETCH-LOGICAL-j2490-7717f806ed547af6a27acf5b3ef0639d2d40349283fa04ff0e7392253601da133 |
| ISSN | 0919-0945 |
| IngestDate | Wed Sep 03 06:22:13 EDT 2025 |
| IsDoiOpenAccess | true |
| IsOpenAccess | true |
| IsPeerReviewed | false |
| IsScholarly | true |
| Issue | 4 |
| Language | Japanese |
| LinkModel | OpenURL |
| MergedId | FETCHMERGED-LOGICAL-j2490-7717f806ed547af6a27acf5b3ef0639d2d40349283fa04ff0e7392253601da133 |
| OpenAccessLink | https://www.jstage.jst.go.jp/article/jacsurg/31/4/31_446/_article/-char/ja |
| PageCount | 7 |
| ParticipantIDs | jstage_primary_article_jacsurg_31_4_31_446_article_char_ja |
| PublicationCentury | 2000 |
| PublicationDate | 20170000 |
| PublicationDateYYYYMMDD | 2017-01-01 |
| PublicationDate_xml | – year: 2017 text: 20170000 |
| PublicationDecade | 2010 |
| PublicationTitle | 日本呼吸器外科学会雑誌 |
| PublicationTitleAlternate | 日呼外会誌 |
| PublicationYear | 2017 |
| Publisher | 特定非営利活動法人 日本呼吸器外科学会 |
| Publisher_xml | – name: 特定非営利活動法人 日本呼吸器外科学会 |
| References | 6. Committee for Scientific Affairs, The Japanese Association for Thoracic Surgery, Masuda M, Kuwano H, Okumura M, Amano J, et al. Thoracic and cardiovascular surgery in Japan during 2012: annual report by The Japanese Association for Thoracic Surgery. Gen Thorac Cardiovasc Surg 2014; 62: 734-64. 11. Nakano T, Endo S, Kanai Y, Otani S, Tsubochi H, Yamamoto S, et al. Surgical outcomes after superior vena cava reconstruction with expanded polytetrafluoroethylene grafts. Ann Thorac Cardiovasc Surg 2014; 20: 310-5. 2. Spaggiari L, Magdeleinat P, Kondo H, Thomas P, Leon ME, Rollet G, et al. Results of superior vena cava resection for lung cancer. Analysis of prognostic factors. Lung Cancer 2004; 44: 339-46. 7. 門松由佳, 中島 潔, 上野陽史, 内山美佳, 森, 正一. 上大静脈の人工血管置換術後に肺塞栓症を発症した1手術例. 日呼外会誌 2016; 30: 561-7. 16. Makutani S, Kichikawa K, Uchida H, Maeda M, Konishi N, Hiasa Y, et al. Effect of antithrombotic agents on the patency of PTFE-covered stents in the inferior vena cava: an experimental study. Cardiovasc Intervent Radiol 1999; 22: 232-8. 17. Spaggiari L, Thomas P, Magdeleinat P, Kondo H, Rollet G, Regnard JF, et al. Superior vena cava resection with prosthetic replacement for non-small cell lung cancer: long-term results of a multicentric study. Eur J Cardiothorac Surg 2002; 21: 1080-6. 1. Bernard A, Bouchot O, Hagry O, Favre JP. Risk analysis and long-term survival in patients undergoing resection of T4 lung cancer. Eur J Cardiothorac Surg 2001; 20: 344-9. 8. Shintani Y, Ohta M, Minami M, Shiono H, Hirabayashi H, Inoue M, et al. Long-term graft patency after replacement of the brachiocephalic veins combined with resection of mediastinal tumors. J Thorac Cardiovasc Surg 2005; 129: 809-12. 15. Gordon BM, Fishbein MC, Levi DS. Polytetrafluoroethylene-covered stents in the venous and arterial system: angiographic and pathologic findings in a swine model. Cardiovasc Pathol 2008; 17: 206-11. 13. Suzuki K, Asamura H, Watanabe S, Tsuchiya R. Combined resection of superior vena cava for lung carcinoma: prognostic significance of patterns of superior vena cava invasion. Ann Thorac Surg 2004; 78: 1184-9. 14. Oizumi H, Suzuki K, Banno T, Matsunaga T, Oh S, Takamochi K. Patency of grafts after total resection and reconstruction of the superior vena cava for thoracic malignancy. Surg Today 2016; 46: 1421-6. 12. Sekine Y, Suzuki H, Saitoh Y, Wada H, Yoshida S. Prosthetic reconstruction of the superior vena cava for malignant disease: surgical techniques and outcomes. Ann Thorac Surg 2010; 90: 223-8. 3. Spaggiari L, Leo F, Veronesi G, Solli P, Galetta D, Tatani B, et al. Superior vena cava resection for lung and mediastinal malignancies: a single-center experience with 70 cases. Ann Thorac Surg 2007; 83: 223-9. 4. Lanuti M, De Delva PE, Gaissert HA, Wright CD, Wain JC, Allan JS, et al. Review of superior vena cava resection in the management of benign disease and pulmonary or mediastinal malignancies. Ann Thorac Surg 2009; 88: 392-7. 10. Shargall Y, de Perrot M, Keshavjee S, Darling G, Ginsberg R, Johnston M, et al. 15 years single center experience with surgical resection of the superior vena cava for non-small cell lung cancer. Lung Cancer 2004; 45: 357-63. 9. Dartevelle PG, Chapelier AR, Pastorino U, Corbi P, Lenot B, Cerrina J, et al. Long-term follow-up after prosthetic replacement of the superior vena cava combined with resection of mediastinal-pulmonary malignant tumors. J Thorac Cardiovasc Surg 1991; 102: 259-65. 5. D'Andrilli A, De Cecco CN, Maurizi G, Muscogiuri G, Baldini R, David V, et al. Reconstruction of the superior vena cava by biologic conduit: assessment of long-term patency by magnetic resonance imaging. Ann Thorac Surg 2013; 96: 1039-45. |
| References_xml | – reference: 10. Shargall Y, de Perrot M, Keshavjee S, Darling G, Ginsberg R, Johnston M, et al. 15 years single center experience with surgical resection of the superior vena cava for non-small cell lung cancer. Lung Cancer 2004; 45: 357-63. – reference: 5. D'Andrilli A, De Cecco CN, Maurizi G, Muscogiuri G, Baldini R, David V, et al. Reconstruction of the superior vena cava by biologic conduit: assessment of long-term patency by magnetic resonance imaging. Ann Thorac Surg 2013; 96: 1039-45. – reference: 9. Dartevelle PG, Chapelier AR, Pastorino U, Corbi P, Lenot B, Cerrina J, et al. Long-term follow-up after prosthetic replacement of the superior vena cava combined with resection of mediastinal-pulmonary malignant tumors. J Thorac Cardiovasc Surg 1991; 102: 259-65. – reference: 14. Oizumi H, Suzuki K, Banno T, Matsunaga T, Oh S, Takamochi K. Patency of grafts after total resection and reconstruction of the superior vena cava for thoracic malignancy. Surg Today 2016; 46: 1421-6. – reference: 11. Nakano T, Endo S, Kanai Y, Otani S, Tsubochi H, Yamamoto S, et al. Surgical outcomes after superior vena cava reconstruction with expanded polytetrafluoroethylene grafts. Ann Thorac Cardiovasc Surg 2014; 20: 310-5. – reference: 2. Spaggiari L, Magdeleinat P, Kondo H, Thomas P, Leon ME, Rollet G, et al. Results of superior vena cava resection for lung cancer. Analysis of prognostic factors. Lung Cancer 2004; 44: 339-46. – reference: 16. Makutani S, Kichikawa K, Uchida H, Maeda M, Konishi N, Hiasa Y, et al. Effect of antithrombotic agents on the patency of PTFE-covered stents in the inferior vena cava: an experimental study. Cardiovasc Intervent Radiol 1999; 22: 232-8. – reference: 15. Gordon BM, Fishbein MC, Levi DS. Polytetrafluoroethylene-covered stents in the venous and arterial system: angiographic and pathologic findings in a swine model. Cardiovasc Pathol 2008; 17: 206-11. – reference: 12. Sekine Y, Suzuki H, Saitoh Y, Wada H, Yoshida S. Prosthetic reconstruction of the superior vena cava for malignant disease: surgical techniques and outcomes. Ann Thorac Surg 2010; 90: 223-8. – reference: 1. Bernard A, Bouchot O, Hagry O, Favre JP. Risk analysis and long-term survival in patients undergoing resection of T4 lung cancer. Eur J Cardiothorac Surg 2001; 20: 344-9. – reference: 6. Committee for Scientific Affairs, The Japanese Association for Thoracic Surgery, Masuda M, Kuwano H, Okumura M, Amano J, et al. Thoracic and cardiovascular surgery in Japan during 2012: annual report by The Japanese Association for Thoracic Surgery. Gen Thorac Cardiovasc Surg 2014; 62: 734-64. – reference: 7. 門松由佳, 中島 潔, 上野陽史, 内山美佳, 森, 正一. 上大静脈の人工血管置換術後に肺塞栓症を発症した1手術例. 日呼外会誌 2016; 30: 561-7. – reference: 17. Spaggiari L, Thomas P, Magdeleinat P, Kondo H, Rollet G, Regnard JF, et al. Superior vena cava resection with prosthetic replacement for non-small cell lung cancer: long-term results of a multicentric study. Eur J Cardiothorac Surg 2002; 21: 1080-6. – reference: 3. Spaggiari L, Leo F, Veronesi G, Solli P, Galetta D, Tatani B, et al. Superior vena cava resection for lung and mediastinal malignancies: a single-center experience with 70 cases. Ann Thorac Surg 2007; 83: 223-9. – reference: 4. Lanuti M, De Delva PE, Gaissert HA, Wright CD, Wain JC, Allan JS, et al. Review of superior vena cava resection in the management of benign disease and pulmonary or mediastinal malignancies. Ann Thorac Surg 2009; 88: 392-7. – reference: 8. Shintani Y, Ohta M, Minami M, Shiono H, Hirabayashi H, Inoue M, et al. Long-term graft patency after replacement of the brachiocephalic veins combined with resection of mediastinal tumors. J Thorac Cardiovasc Surg 2005; 129: 809-12. – reference: 13. Suzuki K, Asamura H, Watanabe S, Tsuchiya R. Combined resection of superior vena cava for lung carcinoma: prognostic significance of patterns of superior vena cava invasion. Ann Thorac Surg 2004; 78: 1184-9. |
| SSID | ssib002223836 ssib002809429 ssib006158315 ssib000936850 ssib005901879 ssj0061428 ssib050939265 ssib003115996 ssib023160720 ssib002484544 ssib058493845 ssib006554584 |
| Score | 2.061305 |
| Snippet | ... |
| SourceID | jstage |
| SourceType | Publisher |
| StartPage | 446 |
| SubjectTerms | 上大静脈 人工血管 再建術式 抗凝固療法 腕頭静脈 |
| Title | 上大静脈および腕頭静脈合併切除を施行した胸部悪性腫瘍症例における血行再建術式と周術期管理の検討 |
| URI | https://www.jstage.jst.go.jp/article/jacsurg/31/4/31_446/_article/-char/ja |
| Volume | 31 |
| hasFullText | 1 |
| inHoldings | 1 |
| isFullTextHit | |
| isPrint | |
| ispartofPNX | 日本呼吸器外科学会雑誌, 2017/05/15, Vol.31(4), pp.446-452 |
| link | http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwrV3NjxRFFO8gXLwYjRgFNRysE5m1pz-qq7hVzfaGQCAxgYTbZGa627gHNLB78cQsXxtwFTQKJBDcZBM2ErkYE6LiP9M7s7P_hb_3qmam13AQ9dKpqX7f76XrvZqu10HwEVb0qFJFv6Wp72xSoE7RaVm0ikGUFrHs9Sv-xtKZs_Lk-eTUhfTCgUNHGm8tra70FwZfvvRcyb_xKubgVzol-wqenRHFBMbwL67wMK7_yMciT4RVQhmRp8IkwmQi10IvCq1FjnnkiUrkMbJFhsEgms_YmGFSoVPCMqEwiy9DB0DIA_BaFDalGfxUjpcmvo6yjkQuhZYEBnQDph3PS2fTwRJTjklsoGNgFGEB3RgehKwFC2asyDOhMV7kQcZMIUYulPUEjd2vIFi0p5raqRhhQx4IL5lgKqwV1vhbOuaZjlBLU8pOdzeYwUDBDmuRCZPTJAkWEk2PlRMMbAIwwoLwebMAYArATT0p0_FcbMeb2jq-2gtApCSzy1i1lNxkJNsBkhj2guVbimyoZtvejejQZDnFL756r1m2AJS10RxeEk_yQ0KGQVx4eLCjkIB9gBjP4V1ouDsRGYPhEQCIHDsHy4gA2XWqMYNlBKbVVMqwuf_kDtrys4IAwcIyF1jXa4wgzVkAcJM-JI32zOFYmrEc2pIinQaslDXH_3cXNLe76bCedq1LF0q32CvVbiGBVc1swOcknzW3unhpT_xWucsSE9d3-e8JCJK7lD98Mbi8eunThbi9MEPb19TdPzK6HrAbt7sJX6hFgL9Hxy4B8FpwKMqyNq3Ypz9plE6aPh3RPMOO5DtubBUkKkmbqbuC9o1SiLps6UarTTqDrhr_2KPSUXGjVJAp_cU-o4eyUIbZvNRE3YFKa_7GBEB1rJLZVoSkzo7c99T7wTXQJXt9vN9aKAWWURhPX6rlPP_cm8EbvkA_Zpx53goOLPfeDjZ2nt8abT3Ze_Rgcm29Ht6q13D9ZXL9-70ff3aTozvrOy9-Ha3f3HuwVa99O_7hxWTzq3p4rx4-nlx9vnd1e7z20_jKk8n1p7v3N3bv3dz583Y9fEqkhnfrtduTzSuAH93YGP3-22Tzu9Ef39TD7dHdbYzHDx_vPtvcvXOjHj4bbz2cbH99ODi_lJ_rnGz5D9m0lqNEhy24L6tUKMsiTbJeJXtR1htUaT8uK6oQi6hIqE0YKr2qFyZVFZYZjBmlsQzbRa8dx-8EBy9-frF8NzimZYkibtCW1FQLRtcFVtWqj0K90FGhy_eCE8563S9ct6LuK4Takf-CfDR4nR4Pbnv6_eDgyqXV8gMUbCv9Dzly_wJNs0rR |
| linkProvider | Colorado Alliance of Research Libraries |
| openUrl | ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=%E4%B8%8A%E5%A4%A7%E9%9D%99%E8%84%88%E3%81%8A%E3%82%88%E3%81%B3%E8%85%95%E9%A0%AD%E9%9D%99%E8%84%88%E5%90%88%E4%BD%B5%E5%88%87%E9%99%A4%E3%82%92%E6%96%BD%E8%A1%8C%E3%81%97%E3%81%9F%E8%83%B8%E9%83%A8%E6%82%AA%E6%80%A7%E8%85%AB%E7%98%8D%E7%97%87%E4%BE%8B%E3%81%AB%E3%81%8A%E3%81%91%E3%82%8B%E8%A1%80%E8%A1%8C%E5%86%8D%E5%BB%BA%E8%A1%93%E5%BC%8F%E3%81%A8%E5%91%A8%E8%A1%93%E6%9C%9F%E7%AE%A1%E7%90%86%E3%81%AE%E6%A4%9C%E8%A8%8E&rft.jtitle=%E6%97%A5%E6%9C%AC%E5%91%BC%E5%90%B8%E5%99%A8%E5%A4%96%E7%A7%91%E5%AD%A6%E4%BC%9A%E9%9B%91%E8%AA%8C&rft.au=%E4%B8%8A%E9%87%8E%2C+%E9%99%BD%E5%8F%B2&rft.au=%E6%A8%AA%E4%BA%95%2C+%E9%A6%99%E5%B9%B3&rft.au=%E5%90%89%E5%B2%A1%2C+%E6%B4%8B&rft.au=%E7%A6%8F%E6%9C%AC%2C+%E7%B4%98%E4%B8%80&rft.date=2017&rft.pub=%E7%89%B9%E5%AE%9A%E9%9D%9E%E5%96%B6%E5%88%A9%E6%B4%BB%E5%8B%95%E6%B3%95%E4%BA%BA+%E6%97%A5%E6%9C%AC%E5%91%BC%E5%90%B8%E5%99%A8%E5%A4%96%E7%A7%91%E5%AD%A6%E4%BC%9A&rft.issn=0919-0945&rft.eissn=1881-4158&rft.volume=31&rft.issue=4&rft.spage=446&rft.epage=452&rft_id=info:doi/10.2995%2Fjacsurg.31.446&rft.externalDocID=article_jacsurg_31_4_31_446_article_char_ja |
| thumbnail_l | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=0919-0945&client=summon |
| thumbnail_m | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=0919-0945&client=summon |
| thumbnail_s | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=0919-0945&client=summon |