血管性脊柱转移性瘤的栓塞和手术之间的最佳时间:系统性审查和元分析
Woon Tak Yuh1,2, Junghoon Han1, Chang-Hyun Lee1,3
1Department of Neurosurgery, Seoul National University Hospital, Seoul, Korea.
Journal of Korean Neurosurgical Society
|June 14, 2023
概括
在24小时内进行完整的栓塞,然后进行早期的脊柱手术,可能会减少高血管脊柱转移患者的手术内出血. 这种时间对于尽量减少手术期间流血至关重要.
科学领域:
- 在瘤学瘤学.
- 干预性放射学 干预性放射学
- 神经外科 神经外科
背景情况:
- 手术前的跨动脉栓塞 (TAE) 旨在减少高血管脊柱转移手术中的血液损失.
- 为了最大限度地减少估计的血液损失 (EBL),TAE和手术之间的最佳时间尚未确定.
研究的目的:
- 通过元分析,评估时间和其他因素在脊髓转移手术期间减少EBL的影响.
主要方法:
- 对比性研究进行了元分析,通过手术对脊髓转移的TAE后时间进行EBL分层.
- 进行了子组分析,以评估影响EBL的各种因素.
主要成果:
- 总的来说,在TAE后的早期 (1-2天) 和晚期手术之间没有发现EBL的显著差异.
- 然而,亚组分析显示,当手术发生在*完全*栓塞后24小时内 (MD,233.3 mL;p=0.004) 时,出血明显减少.
- 部分栓塞并没有显示基于时间的EBL显著差异.
结论:
- 在24小时内进行早期脊柱手术后的完全栓塞与减少手术内出血有关.
- 这种策略可能对经过外科手术的高血管脊髓转移患者有益.
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