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A Technique for Taping Inferior Vena Cava Caudal to the Duodenum: Duodenal Penetration by IVC Filter Strut after Retroperitoneal Lymph Node Dissection—usefulness of the Mesenteric Approach

Surgical case reports(2019)

Second Department of Surgery

Cited 3|Views47
Abstract
BACKGROUND:Although an inferior vena cava (IVC) filter is used for preventing pulmonary thromboembolism (PTE) in patients with deep vein thrombosis, IVC filter penetration in the duodenum is a rare complication.CASE PRESENTATION:A 35-year-old man had previously undergone retroperitoneal lymph node dissection (RPLND) for testicular cancer and IVC filter placement for prevention of PTE. Esophagogastroduodenoscopy (EGD) for his epigastric pain revealed penetration of the IVC filter in the duodenum. The IVC filter was retrieved through cavotomy, and the duodenal penetration was repaired using EGD clipping. Although it was difficult to mobilize the duodenum due to adhesion resulting from RPLND, the use of a mesenteric approach enabled encircling of the IVC caudal to the duodenum. The mesenteric approach is useful and safe for taping the IVC caudal to the duodenum in cases where it is difficult to mobilize the duodenum.CONCLUSION:IVC taping using the mesenteric approach allowed safe retrieval of the IVC filter after RPLND without postoperative complications.
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Inferior vena cava filter,Retroperitoneal lymph node dissection,Mesenteric approach
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要点】:论文提出了一种在腹膜后淋巴结清扫术后,采用肠系膜途径对下腔静脉滤器穿透十二指肠进行安全固定和移除的方法。

方法】:通过肠系膜途径对下腔静脉滤器进行固定,并在内镜下使用夹子修复十二指肠穿透部位。

实验】:研究案例为一例35岁男性患者,之前因睾丸癌接受腹膜后淋巴结清扫术和下腔静脉滤器置入预防肺血栓栓塞,后因上腹痛进行胃镜检查发现滤器穿透十二指肠。通过开窗术移除滤器,并利用胃镜下夹闭技术修复穿透。结果显示肠系膜途径在难以移动十二指肠的情况下,对下腔静脉进行固定是有效和安全的,未出现术后并发症。未提及具体数据集名称,因为本研究为案例报告。