LeVeen—腹腔静脈シャント植え込み手術を施行したstage IV腎癌の1例

A CASE REPORT: LEVEEN'S PERITONEO-VENOUS SHUNT IMPLANT IN STAGE IV HYPERNEPHROMA

緒言

　癌性腹膜炎において，抗癌療法が無効である場合，一般に腹水による腹部膨満の改善は水，Naの摂取制限，利尿剤投与，プラズマネートなどの輸液などの保存的治療では難しく，もつばら腹腔穿刺によらなければならない。

　今回，著者らは聖路加国際病院泌尿器科において肝肺転移および癌性腹膜炎を伴つた左側腎癌症例に腹部膨満による食欲不振の改善と腹腔穿刺よりの解放を目的にLeVeen—腹腔静脈シャント植え込み手術を施行し^1），満足すべき結果を得たので報告する。

The case was a 50-year-old man, diagnosed as left renal cell carcinoma with liver metastasis on the fist admission. He had been receiving medroxy progesterone acetate at the O.P.D. for 2 months. He was readmitted because of panperitonitis carcinomatosa. Chemotheraphy with vinblastine was started in addition to the endocrine theraphy. Moreover, it was necessary to make frequent abdominal punctures to relieve the abdominal distension due to ascites.

In spite of these treatment, pulmonary metastasis occurred.