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相关概念视频

Kidney Transplant I: Introduction01:28

Kidney Transplant I: Introduction

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A kidney transplant is a surgical approach that involves replacing a non-functioning kidney with a healthy one from a donor. This procedure is often a treatment option for end-stage renal disease (ESRD) patients. The method requires careful recipient selection, including evaluating various medical and psychosocial factors. These criteria vary between transplant centers but generally include assessments of the patient's overall health, adherence to medical recommendations, and lifestyle...
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Kidney Transplant II: Surgical Procedure01:26

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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...
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Kidney Transplant III: Nursing Management01:16

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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...
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The Influence of Liver Resection on Intrahepatic Tumor Growth
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在接受结直肠肝转移的第二次和第三次切除的患者中,复发的风险不会降低.

Yuhi Yoshizaki1, Yoshikuni Kawaguchi2, Yusuke Seki2

  • 1Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan; Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, National Centre for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan.

HPB : the official journal of the International Hepato Pancreato Biliary Association
|April 9, 2025
PubMed
概括

对结直肠肝转移 (CLM) 进行重复肝切除,与第一次相比,第二次和第三次手术的复发风险类似. 监测策略应在重复的CLM切除中保持一致.

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科学领域:

  • 在瘤学瘤学.
  • 手术瘤学手术瘤学
  • 肝胆道手术 肝胆道手术

背景情况:

  • 重复切除肝脏是复发性结直肠肝转移 (CLM) 的标准治疗方法.
  • 在第二次和第三次CLM切除后复发的风险尚未先前评估.
  • 了解重复切除后的复发模式对于优化患者管理至关重要.

研究的目的:

  • 评估和比较第一次,第二次和第三次肝脏切除后复发的风险.
  • 为了确定第二次CLM切除后复发的风险因素.
  • 为CLM重复切除肝脏后的监测策略提供信息.

主要方法:

  • 对前性维护的数据库进行回顾性分析.
  • 包括在2005年至2018年期间接受第一次,第二次或第三次CLM切除的患者.
  • 统计分析以比较复发风险并确定风险因素.

主要成果:

  • 来自695名患者的数据:486人 (第一次),159人 (第二次) 和50人 (第三次切除).
  • 复发风险和累积复发曲线在第一个,第二个和第三个CLM切除中是相似的.
  • 第二次切除后复发的显著风险因素包括第一次切除后 ≤12个月的复发时间 (HR 2.09) 和CLM的数量 (HR 1.07).

结论:

  • 接受第二次和第三次CLM切除的患者面临的复发风险与第一次切除的患者相似.
  • 目前在第一次CLM切除后采用的监测策略适用于接受后续切除的患者.
  • 在CLM患者的所有重复肝切除术中,建议采用一致的监测方案.