[小质量的积极监测]
Thomas Jaugey1, François Crettenand1, Nuno Grilo1
1Service d'urologie, Département de chirurgie, Centre hospitalier universitaire vaudois, 1011 Lausanne.
Revue medicale suisse
|November 28, 2024
概括
针对小质 (SRM) 的积极监测是手术的安全替代方案,特别是对于高风险患者. 密切监测允许延迟干预,如果瘤进展.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 在瘤学瘤学.
- 诊断成像 诊断成像 诊断成像
背景情况:
- 定义为<4厘米的瘤的小脏质量 (SRMs),由于医学成像学的进步,经常偶然发现.
- 虽然许多SRM是良性的,但它们的管理存在临床挑战.
- 目前的管理策略通常涉及手术干预,这可能会带来风险.
研究的目的:
- 评估主动监测 (AS) 作为小质的管理策略.
- 在当前治疗选择的背景下讨论AS的好处和局限性.
主要方法:
- 关于小质量和主动监测的现有文献的审查.
- 根据积极监测协议对患者结果的分析.
- 积极监测与手术干预对SRM进行比较.
主要成果:
- 积极监测是管理SRM的验证方法,特别是在具有重大外科风险或寿命有限的患者中.
- 在AS期间定期进行成像,可以及时检测瘤进展,必要时可以推迟手术干预.
- 研究表明,AS可以在精选的SRM病例中实现与即时手术相比较的瘤控制.
结论:
- 积极监测代表了小质的可行和安全的管理选项.
- 对于AS的采用障碍包括缺乏标准化的协议和越来越多的微创手术技术的可用性.
- 需要进一步的研究和准则制定,以优化对SRM的积极监测的实施.
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