JPH05261115A - Catheter system for treating liver cancer - Google Patents

Abstract

PURPOSE:To provide a catheter system for treating liver cancer in which a catheter is surgically left inside the body and the stop and restart of the blood flow in a portal vein is repeated by the operation from the outside of the body for eradicating hepatic cancer cells. CONSTITUTION:A liver-cancer treating catheter system for treating liver cancer comprises a catheter consisting of a slender flexible tube 1 and a piston 2 that has been inserted into the tube 1, a moving means for moving the piston 2 in the inside of the tube 1, a retaining means by which a portal vein 3 is held at the end of the tube 1 and also the portal vein is closed or released in cooperation with the movement of the piston 2, and a fixing means by which the piston 2 is releasably fixed in its moving position.

Description

Detailed Description of the Invention

[0001]

FIELD OF THE INVENTION The present invention relates to a liver cancer treatment catheter system. Specifically, a catheter with a piston inserted is placed in the body, and the piston is moved from outside the body,
The present invention relates to a catheter system for erasing liver cancer cells by repeatedly stopping / restarting blood flow in the portal vein in cooperation with a means for retaining the portal vein.

[0002]

BACKGROUND OF THE INVENTION Liver cancer has generally been treated by chemotherapy or surgery, or a combination of chemotherapy and surgery. Liver cancer resection surgery is not only for patients,
The strain on the surgeon was also heavy. Therefore, a technique of repeating temporary occlusion and release of the portal vein supplying blood to the liver has been adopted. That is, when the portal vein is occluded and the liver is in an ischemic state, the functions of both normal cells and cancer cells in the liver are reduced. However, when the blood flow is restarted, the function of normal cells is rapidly restored, but the ability of cancer cells to recover the function is inferior to that of normal cells. In this way, treatment for eradicating liver cancer has come to be performed by repeatedly stopping and restarting blood flow to the liver based on liver function test data.

[0003]

In order to repeatedly stop and restart the blood flow to the liver, it is necessary to ligate the portal vein with a suture or to release the ligation by laparotomy every time. Therefore, not only the operation cost becomes high, but also the burden on the patient and the surgeon is large, and the risk of infection during the operation is great.

[0004]

In order to solve the above problems, the liver cancer treatment catheter system of the present invention comprises a catheter comprising an elongated flexible tube and a piston inserted in the tube, and Moving means for moving the piston, holding means for holding the portal vein at the tip of the tube, and closing / releasing the portal vein in cooperation with the movement of the piston, and releasing the piston in the moving position It consists of fixing means for fixing as much as possible.

[0005]

[Function] The catheter of the present invention is surgically placed in the body,
The holding means holds the portal vein at the tip of the tube. For example, the suture is tied in a state where the portal vein is surrounded by two sutures provided at the distal end of the tube, and the portal vein is retained at the distal end of the tube, and then the proximal end of the tube To close the wound. When the piston is moved by an operation from outside the body, for example, when the plunger of the syringe connected to the proximal end of the tube is pushed to move the liquid filled between the plunger and the piston, the piston moves forward. , The portal vein is sandwiched between the piston and the suture and occluded, the blood flow to the liver is blocked, and the fixing means provided outside the body under the blood flow blocking state, for example, the The piston is fixed by prohibiting the movement of the liquid by operating a cock interposed between the proximal end of the tube and the injection cylinder. After releasing the fixing means, the blood flow is restarted by retreating the piston based on the data of the liver function test. When such stopping and resuming of blood flow is repeated, liver cancer cells vulnerable to ischemia are eradicated, and cells other than liver cancer cells are rapidly recovered to a normal state.

[0006]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS An embodiment of the liver cancer treatment catheter system of the present invention will be described below with reference to the drawings. 1 and 2
Each of the drawings is a partially cutaway side view of the embodiment of the present invention,
FIG. 3 is a partially cutaway side view showing a main part of another embodiment. 1, a catheter system for treating liver cancer according to the present invention comprises a catheter including an elongated flexible tube 1 and a piston 2 inserted in the tube, and a moving means for moving the piston 2 in the tube 1. The tube 1
Holding means for holding the portal vein 3 at the distal end portion thereof and closing / releasing the portal vein in cooperation with the movement of the piston 2, and fixing means for releasably fixing the piston 2 in the moving position. Become. The tube 1 is made of, for example, a plastic generally used for catheters, and it is desirable that a mesh for reinforcement be embedded in the main body. The piston 2 is made of, for example, an elastic material such as silicone having excellent biocompatibility. The holding means is, for example, a thread attached to the distal end of the tube 1, for example, two sutures 11. The holding means surrounds the portal vein 3 for supplying blood to the liver by laparotomy and then ties the tube 1 together.
It is used to hold the portal vein 3 at the tip of the. The portal vein 3
After holding, the proximal end side of the tube 1 is guided outside the body to close the wound. A means connected to the base end of the tube 1 for changing the amount of liquid in the tube 1 on the downstream side of the piston 2, for example, by pushing the plunger 41 of the injection cylinder 4 to push the plunger 41 and the piston 2 between them. Filled liquid,
For example, when raw food is pushed out, the piston 2 advances, the portal vein 3 is occluded by the cooperation of the piston 2 and the suture thread 11, and the blood flow to the liver is blocked. Under the condition where the blood flow is blocked, the movement of the liquid is prohibited by a means for prohibiting the change in the amount of the liquid, for example, the operation of the cock 5 interposed between the proximal end portion of the tube 1 and the injection cylinder 4. To fix the position of the piston 2. Based on the data of the liver function test, the cock 5 is operated to release the movement prohibition, and then the piston 41 is retracted when the plunger 41 is retracted, so that the blood flow in the portal vein 3 is restarted. Further, the movement amount of the piston 2 can be estimated from the movement amount of the plunger 41 with reference to the scale of the injection cylinder 4. When such stopping and resuming of blood flow is repeated, liver cancer cells that are vulnerable to ischemia are eradicated, and cells other than liver cancer cells rapidly recover to a normal state.
When the eradication of liver cancer cells is confirmed, the suture is cut under abdominal laparotomy, and then the catheter is taken out of the body and closed. Although not shown, a hollow subcutaneous implantable valve communicating with the proximal end of the tube 1 is placed under the skin,
Post-puncture self-occlusive rubber septum provided on the skin side of the valve is percutaneously punctured by a syringe, and the piston is advanced by the movement of the liquid due to the advancement of the plunger of the syringe to occlude the portal vein 3. If the syringe is removed, the movement of the liquid is prohibited due to the self-closing property of the rubber septum. To restart the blood flow in the portal vein, the rubber septum may be punctured with the syringe to suck the liquid. When the above subcutaneous implantable valve is used, all but the syringe can be left inside the body, and therefore infection can be completely prevented only by disinfecting the skin surface before and after puncturing.
In FIG. 2, the holding means is a thread attached to the tip of the piston 2, for example, two sutures 21,
It is used to hold the portal vein 3 at the tip of the tube 1 as in the first embodiment. When the piston 2 is retracted, the portal vein 3 is attached to the tube 1 by the suture 21.
It is drawn in and occludes and blood flow stops. In the present embodiment, the moving means of the piston 2 is a flexible piston rod 6, and the piston 2 is moved by operating the piston rod 6 from outside the body. Any clamp, not shown, which secures the piston rod 6 outside the end can be used.
Of course, the moving means and the fixing means of the first embodiment can be adopted. In FIG. 3, the holding means is a U-shaped member 12 provided at the distal end portion of the tube 1, and the member 12 can be made of, for example, a plastic having excellent biocompatibility and having resilience. A detachable notch 13 is provided on the side surface of the member 12. The notch 13 is forcibly opened laterally to open the portal vein to the U-shaped member 12.
When the notch 13 is returned to its original position after being housed inside, the portal vein is retained in the U-shaped member 12. The occlusion and release of the portal vein is performed according to the above embodiment.

[0007]

EFFECT OF THE INVENTION Since the catheter system for treating liver cancer of the present invention has the above-mentioned configuration, it does not require a high operation cost because it requires an operation only when the catheter is placed and when it is removed. Stopping and restarting blood flow to the liver can be easily repeated from outside the body. Therefore, not only the patient but also the burden on the doctor in charge is reduced, and as in the conventional case, ligation of the portal vein with a suture is performed by open surgery each time,
There is no need to release the ligature, and the risk of infection during the operation is reduced.

[Brief description of drawings]

FIG. 1 is a partially cutaway side view of an embodiment of a liver cancer treatment catheter system of the present invention.

FIG. 2 is a partially cutaway side view of another embodiment of the liver cancer treatment catheter system of the present invention.

FIG. 3 is a partially cutaway side view showing a main part of another embodiment of the catheter system for treating liver cancer of the present invention.

[Explanation of symbols]

1 is a tube, 2 is a piston, 3 is a portal vein, 4 is a syringe,
5 is a cock, 6 is a piston rod, 11 is a suture thread, 12
Is a U-shaped member, 13 is a notch, 21 is a suture thread, 4
1 is a plunger.

Claims (8)

[Claims] 1. A catheter comprising an elongated flexible tube and a piston inserted in the tube, a moving means for moving the piston in the tube, and a portal vein at the distal end of the tube. A catheter system for treating liver cancer, comprising: a holding means for closing / releasing the portal vein in cooperation with the movement of the piston, and a fixing means for releasably fixing the piston in the moving position. 2. The liver cancer treatment catheter system according to claim 1, wherein the holding means is a thread attached to the distal end portion of the tube. 3. The liver cancer treatment catheter system according to claim 1, wherein the holding means is a thread attached to the tip of the piston. 4. The liver cancer treatment catheter system according to claim 1, wherein the holding means is a U-shaped member provided at the tip of the tube and having a notch on the side surface. 5. The moving means is means for changing the amount of liquid in the tube on the downstream side of the piston, and the fixing means is means for prohibiting the change of the amount of liquid. The catheter system for treating liver cancer according to claim 1. 6. The moving means is a flexible piston rod fixed to the rear end surface of the piston, and the fixing means is a clamp for fixing the piston rod at the proximal end portion of the tube. The liver cancer treatment catheter system according to claim 1. 7. The liquid quantity changing means is an injection cylinder connected to the proximal end of the tube, and the means for inhibiting the change of the liquid quantity is provided between the proximal end of the tube and the injection cylinder. 6. The liver cancer treatment catheter system according to claim 5, wherein the cock is an intervening cock. 8. A hollow subcutaneous implantable valve in which the liquid amount changing means communicates with a proximal end portion of the tube and which can be placed under the skin, and a self-puncturing post-puncture provided percutaneously on the skin side of the valve. The hepatic cancer treatment catheter according to claim 5, which is a combination with an injector capable of puncturing an occlusive rubber septum, and the means for inhibiting the change in the liquid amount is the rubber septum.