放射性肠炎的手术前出现:应该切除什么?
Jade Fawaz1, Olivier Lucidarme2, Marc Pocard3
1Department of Digestive, Hepatobiliary Surgery and Liver Transplantation, Pitié-Salpêtrière Hospital, AP-HP, 47-83, boulevard de l'Hôpital, 75013 Paris, France.
Journal of visceral surgery
|October 20, 2023
概括
放射性肠炎是放射治疗的延迟并发症,通常呈现为慢性肠道阻塞. 当医疗治疗,如皮质类固醇治疗,证明无效时,需要进行手术,包括肠切除和内肠去除.
科学领域:
- 胃肠病学 胃肠病学
- 在瘤学瘤学.
- 手术科学 手术科学
背景情况:
- 放射性肠炎是放射治疗后的一个显著的长期并发症.
- 它通常表现为慢性肠道阻塞,与急性辐射效应不同.
- 延迟发病,治疗后长达30年,是特征.
研究的目的:
- 概述放射性肠炎的临床表现和治疗方法.
- 突出在耐火病例中进行手术干预的指示.
- 描述手术方法,包括肠切除和大肠膜切除.
主要方法:
- 对放射性肠炎的临床病例和治疗结果的审查.
- 对放射治疗后的慢性肠道阻塞的诊断标准的分析.
- 评估医疗 (皮质类固醇) 与手术管理的疗效.
主要成果:
- 慢性肠道阻塞是辐射肠炎的主要表现.
- 皮质类固醇治疗是首选的初始医疗治疗.
- 当医疗管理失败时,受影响的肠道的手术切除,通常涉及大肠门,是适合的.
结论:
- 辐射性肠炎需要高度的怀疑指数,以延迟肠道阻塞.
- 有效的管理取决于在必要时及时从医疗治疗升级到手术治疗.
- 手术切除与排骨膜切除是严重的绝对治疗方法,耐辐射性肠炎.
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