高龄患者上管泌尿道癌脏切除术后功能变化
Tatsuya Kawamura1, Daiki Ikarashi1, Arisa Machida2
1Urology, Iwate Medical University, Yahaba-cho, JPN.
Cureus
|July 2, 2024
概括
激进脏切除术可能会降低脏功能,特别是在老年患者中. 水性与上道泌尿器官癌症的老年人手术后更好的功能结果有关.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 腎臟病學 (nephrology) 是一種醫學.
- 在瘤学瘤学.
背景情况:
- 针对上道泌尿道癌 (UTUC) 的激进瘤切除术 (RNU) 可能会损害功能,影响辅助化疗决策.
- 评估RNU后的功能变化至关重要,特别是在老年患者中.
研究的目的:
- 在老年UTUC患者中确定与RNU后功能变化相关的临床因素.
- 根据年龄 (≥75岁和<75岁) 分层分析,以了解特定年龄的影响.
主要方法:
- 评估了145名为UTUC接受RNU的患者.
- 在手术前,手术后和1个月后测量估计的淋巴膜过率 (eGFR),每年进行长期随访.
- 使用单变量和多变量分析,按年龄分层.
主要成果:
- 中位数eGFR在RNU后显著下降 (57.1至36.1手术前至后).
- 老年患者 (≥75岁) 呈现显著下降,仅有8%的患者在1个月后仍然有资格接受西斯丁 (eGFR ≥50).
- 水性 (HN) 已成为75岁以上患者功能保存的重要预测因素.
结论:
- 患有水性的老年患者接受UTUC的RNU,可能患有显著功能下降的风险较低.
- 这些发现可以为这个脆弱人群的辅助治疗决定提供信息.
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