肝胆胰外科杂志2025，Vol.37Issue(11)：727-730,4.DOI:10.11952/j.issn.1007-1954.2025.11.002
腹腔镜下取出透壁锥形下腔静脉滤器的临床观察
The clinical observation of laparoscopic retrieval of transmural conical inferior vena cava filters
高鹏骥 1刘建龙 2吴蔚 1王欣 1赵轶国 1蒋鹏 2田轩 2贾伟2
作者信息
- 1. 首都医科大学附属北京积水潭医院 普外科,北京 100035
- 2. 首都医科大学附属北京积水潭医院 血管外科,北京 100035
- 折叠
摘要
Abstract
Objective To evaluate the clinical efficacy of laparoscopic retrieval of transmural conical inferior vena cava(IVC)filters and explore the feasibility of selecting a transmesocolic approach(cephalad or caudal)based on the penetration site of the filter hook into the IVC wall.Methods This prospective study enrolled patients scheduled for surgical removal of transmural conical IVC filters at Beijing Jishuitan Hospital,Capital Medical University,between April 2023 and April 2025.Preoperative abdominal contrast-enhanced CT was performed to assess the penetration site of the filter hook.The laparoscopic approach(cephalad or caudal to the transverse mesocolon)was determined by the hook's position relative to the right renal vein.Clinical data,including operative time,intraoperative blood loss,postoperative hospital stay,and complications,were recorded.Results Among 24 initially evaluated patients,2 underwent open surgery due to contraindications for laparoscopy.The remaining 22 patients underwent laparoscopic surgery:8 via the cephalad approach and 14 via the caudal approach,with 2 conversions to open surgery.The complete laparoscopic success rate was 90.9%.Mean operative time was(110.1±44.4)min[range:(38-165)min],and mean blood loss was(69.4±184.0)mL[range:(5-800)mL].One patient(4.6%)required transfusion due to IVC wall laceration.Mean postoperative hospitalization was(7.3±1.5)days,with no complications.Conclusion Laparoscopic retrieval of transmural conical IVC filters is a safe and reliable technique.Selecting the surgical approach based on the hook's penetration site minimizes the operative field and reduces trauma.Intraoperative ultrasound can aid in locating posterior IVC wall penetrations,facilitating precise hook localization and expediting the procedure.关键词
透壁锥形下腔静脉滤器/腹腔镜手术/滤器取出Key words
transmural conical inferior vena cava filter/laparoscopic surgery/filter retrieval分类
医药卫生引用本文复制引用
高鹏骥,刘建龙,吴蔚,王欣,赵轶国,蒋鹏,田轩,贾伟..腹腔镜下取出透壁锥形下腔静脉滤器的临床观察[J].肝胆胰外科杂志,2025,37(11):727-730,4.
