在85岁或以上的患者中,对脏瘤进行 laparoscopic 瘤手术
P Izquierdo1, J Huguet1, A Bravo-Balado2
1Servicio de Urología, Fundació Puigvert, Universitat Autònoma de Barcelona, Barcelona, Spain.
Actas urologicas espanolas
|February 15, 2025
概括
在85岁以上的患者中,腹腔镜癌手术是可行的,但具有很高的风险,特别是对于尿路瘤. 对手术风险进行全面的患者咨询对于明智的决策至关重要.
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
- 老年医学 老年医学
背景情况:
- 老年患者在重大瘤手术中存在独特的挑战.
- 腹腔镜治疗方法越来越多地用于脏和尿路瘤.
研究的目的:
- 在85岁及以上的患者中分析腹腔镜激进切除术和尿切除术的可行性和结果.
- 在这个特定的老年人群中评估并发症和生存率.
主要方法:
- 对47名患者 (≥85岁) 进行脏或尿路瘤的大型腹腔镜手术的回顾性审查.
- 对临床病理学数据,术后并发症 (克拉维恩分类) 和生存结果的分析.
主要成果:
- 进行了15次彻底切除术 (脏瘤) 和32次脏切除术 (尿路瘤).
- 在管切除组中观察到更高的并发症率和更低的生存率,特别是在侵入性瘤中.
- 癌症特异性5年生存率:73% (脏) 与45% (尿道);整体生存率:40% (脏) 与30% (尿道).
结论:
- 在老年患者 (≥85岁) 中,腹腔镜脏瘤手术是可行的.
- 这些程序与显著的病死亡率有关,特别是对于尿路瘤.
- 对这个患者群体来说,讨论高手术风险的知情同意至关重要.
相关概念视频
01:18Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion
In geriatric patients, renal physiology undergoes significant changes, including diminished renal blood flow and a lower glomerular filtration rate (GFR), leading to alterations in medication clearance. Drugs such as aminoglycoside antibiotics, lithium, and digoxin, which rely on glomerular filtration for removal from the body, particularly impact pharmacokinetics. These drugs tend to have slower clearance rates in older adults, necessitating careful dosage considerations.Evaluation of renal...
01:26Kidney Transplant II: Surgical Procedure
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 donor...