在癌中进行切除术和IVC血栓切除术:叙述性综述
Ali Faegh1, Aysan Moeinafshar2, Nima Rezaei3,4,5
1School of Medicine, Alborz University of Medical Sciences, Karaj, Iran.
概括
根性切除与下腔静脉 (IVC) 血栓切除治疗晚期癌,但复杂. 本综述比较了IVC血栓切除术的开放式和微创手术技术,旨在获得最佳的患者结果.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 手术瘤学手术瘤学
- 血管外科 血管外科
背景情况:
- 细胞癌 (RCC) 可以导致下腔静脉 (IVC) 血栓形成,显著降低5年生存率.
- 根性切除术和IVC血栓切除术是IVC参与的RCC的标准治疗方法.
- 在IVC血栓切除术的手术管理中,存在重大外科手术期间的挑战和争议.
研究的目的:
- 审查和比较细胞癌中IVC血栓切除术的最新手术策略.
- 评估IVC血栓切除术的开放式,腹腔镜和机器人方法的疗效和安全性.
- 分析基于瘤水平和脏侧向性的手术方法.
主要方法:
- 对IVC血栓切除术的外科手术技术的综合文献综述.
- 对开放式,腹腔镜和机器人手术方法的比较分析.
- 根据IVC血栓形成水平 (III和IV) 和脏来源 (左/右) 的方法分层.
主要成果:
- 最少侵入性技术正在越来越多地取代IVC血栓切除的开放方法.
- 对于左癌与右癌以及不同的IVC血栓形成水平,存在特定的挑战.
- 对复杂的IVC血栓切除术的最佳手术技术的证据正在发展.
结论:
- 进行IVC血栓切除术的最佳手术技术取决于瘤的扩展程度和患者的解剖学.
- 微创手术具有潜在的优势,但需要专门的专业知识.
- 需要进一步的研究,以建立标准化IVC血栓切除术的最佳实践.
相关概念视频
01:29Venous Thrombosis III: Interprofessional Care
10
Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
10
01:26Kidney Transplant II: Surgical Procedure
36
Preoperative ManagementThe primary goals of preoperative management in kidney transplantation are to optimize the patient’s metabolic state and prepare them for surgery through diet adjustments, necessary dialysis, and tailored medical treatment. This phase also involves comprehensive infection screening and patient education about the surgical procedure and postoperative care to improve outcomes and adherence.Medical ManagementA comprehensive evaluation is required for both the living...
36
01:29Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care
10
Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
10
01:30Acute Kidney Injury IV: Diagnostic Studies and Prevention
35
Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
35
01:19Imaging Studies VII: Vascular Imaging
31
DefinitionRenal angiography, also known as renal arteriography, is an imaging technique used to obtain a comprehensive view of blood flow and the vascular structure of blood vessels in the kidneys and surrounding areas.PurposeRenal angiography detects blood vessel abnormalities in the kidneys, such as aneurysms, stenosis, thrombosis, vascular tumors, and renal artery stenosis. It evaluates kidney function and guides interventional treatments like angioplasty or stent placement.Pre-Procedure...
31
01:16Kidney Transplant III: Nursing Management
39
Postoperative Nursing Management for Kidney Transplant PatientsPostoperative nursing management care includes monitoring the surgical site, encouraging early movement, and promoting lung health through breathing exercises. Nurses also administer prescribed medications like H2-blockers, such as famotidine, or proton pump inhibitors, like omeprazole, to help prevent gastrointestinal ulcers and bleeding. Fungal infections in the mouth and bladder can result from immunosuppressive and antibiotic...
39