膀和前列腺癌手术中的骨盆淋巴结剖析以及术后静脉血栓栓塞的风险
Juhana Rautiola1, Johan Björklund1, Renata Zelic1
1Department of Molecular Medicine and Surgery, Karolinska Institutet and Department of Pelvic Cancer, Karolinska University Hospital, Stockholm, Sweden.
概括
在急性囊切术后的盆腔淋巴结剖析不会增加静脉血栓塞栓症的风险. 然而,它与激进前列腺切除术后肺栓塞和深静脉血栓塞 (DVT) 的风险较高有关.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 血管外科 血管外科
- 在瘤学瘤学.
背景情况:
- 激进囊切除术和激进前列腺切除术分别是膀癌和前列腺癌的常见手术.
- 盆腔淋巴结解剖通常与这些手术同时进行.
- 静脉血栓栓塞事件 (VTE),包括肺栓塞 (PE) 和深静脉血栓塞 (DVT),是大手术后的潜在并发症.
研究的目的:
- 评估骨盆淋巴结解剖与进行激进囊切除术或激进前列腺切除术的患者中静脉瘤风险之间的关联.
- 为了比较每个手术手术的骨盆淋巴结剖析和没有骨盆淋巴结剖析的患者的VTE风险.
主要方法:
- 从1997年至2016年,对瑞典全国性注册的回顾性分析.
- 包括接受了膀癌激进囊切除术或前列腺癌激进前列腺切除术的患者.
- 后勤回归分析以估计PE和DVT的几率比率,根据淋巴结解剖概率进行调整.
主要成果:
- 总共分析了6069名急性囊切除术和36911名急性前列腺切除术患者.
- 带有淋巴结解剖的激进囊切除术没有与PE (OR 0.99) 或DVT (OR 0.99) 有意义的关联.
- 淋巴结剖开的急性前列腺切除与明显更高的PE (OR 2.29) 和DVT (OR 2.95) 的几率有关.
结论:
- 骨盆淋巴结剖析不会增加根基囊切除术后静脉瘤的风险.
- 在急性前列腺切除术期间的淋巴结解剖与VTE的相对风险增加有关,包括PE和DVT.
相关概念视频
01:23Peripheral Artery Disease V: Postoperative Nursing Management
26
During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
26
01:29Venous Thrombosis III: Interprofessional Care
23
Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
23
01:30Venous Thrombosis IV: Nursing Management
24
Nursing management begins with a thorough assessment of the patient's health history. Key factors include trauma to veins, peripherally inserted central catheters, varicose veins, recent pregnancy or childbirth, surgery, bacteremia, prolonged bed rest, atrial fibrillation, COPD, heart failure, cancer, coagulation disorders, myocardial infarction, spinal cord injury, stroke, prolonged travel, recent bone fractures, and dehydration. Review medication intake, particularly oral contraceptives,...
24
01:20Venous Thrombosis II: Clinical Manifestations and Diagnostic Studies
37
The key difference between Superficial Vein Thrombosis (SVT) and Deep Vein Thrombosis (DVT) lies in their location and severity.Clinical ManifestationsSVT typically presents with localized pain, tenderness, and redness along the course of a superficial vein, often accompanied by a palpable, cord-like structure under the skin. This condition is usually less dangerous than DVT but can be uncomfortable and may lead to complications such as cellulitis or, rarely, a clot extension into the deep...
37
01:30Venous Thrombosis I: Introduction
42
Venous thrombosis, the most common disorder of the veins, involves the formation of a thrombus or blood clot associated with vein inflammation. It can be classified as either superficial vein thrombosis or deep vein thrombosis.Superficial Vein Thrombosis: This involves the formation of a thrombus in a superficial vein, usually the greater or lesser saphenous vein. Though less severe than deep vein thrombosis (DVT), SVT can lead to complications if untreated.Deep Vein Thrombosis (DVT): This...
42
01:26Varicose Veins II: Diagnostic Studies and Interprofessional Care
32
Varicose veins, or varicosities, develop when the valves in the veins, which control blood flow, weaken or damage. It causes blood to pool and the veins to enlarge. Understanding the clinical manifestations, diagnostic approaches, and management options for varicose veins is crucial for effective treatment and relief.Clinical manifestationsClinical manifestations of varicose veins include a heavy, achy feeling or pain after prolonged standing or sitting. This discomfort can often be relieved by...
32