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ARTICLE |

Suprarenal-Inferior Mesenteric Venous Shunt for Advanced Carcinoma of the Breast

KIYOSHI INOKUCHI, MD, DSc; TAIJI IKEJIRI, MD
Arch Surg. 1966;92(6):853-856. doi:10.1001/archsurg.1966.01320240041008.
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THE suprarenal-splenic venous shunt was first performed in 1954 by Galante and associates1 in four patients with far-advanced carcinoma of the breast. The operation is clinically significant not only as an adjuvant to simple bilateral oophorectomy originated by Beatson,2 but also as a possible means of abolishing the substitution therapy necessary after bilateral ablation of the suprarenal glands devised by Huggins and associates.3

The shunting procedure, however, is associated with certain difficulties: (1) the necessity of splenectomy, which increases not only the extent of operation but also the unfavorable effects of body resistance to cancer; and (2) technical difficulty of anastomosing the splenic vein to the small suprarenal vein. To overcome these difficulties, one of us (Inokuchi4,5) began using a branch of the inferior mesenteric vein for anastomosis of the suprarenal vein instead of the splenic vein, as in Galante's procedure; this method eliminates splenectomy. Although

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