耐火性免疫检查点抑制剂相关性结肠炎的乳房切除术:一个病例报告和文献综述
相关实验视频
Updated: Jan 12, 2026
08:49
Murine Ileocolic Bowel Resection with Primary Anastomosis
Published on: October 29, 2014
17.1K
Koji Daito1, Masahiro Haeno1, Issei Umeda1
1Department of Surgery, Kindai University Faculty of Medicine, Osaka, JPN.
Cureus
|October 31, 2025
概括
免疫检查点抑制剂相关大肠炎 (irAE大肠炎) 可能对标准治疗不耐药. 在耐火病例中,转向环结节切除术提供了症状缓解,尽管长期结果需要进一步调查.
科学领域:
- 在瘤学瘤学.
- 免疫学 免疫学 免疫学
- 胃肠病学 胃肠病学
背景情况:
- 免疫检查点抑制剂 (ICI) 彻底改变了癌症治疗,但可以引起与免疫相关的不良事件 (irAEs).
- 免疫检查点抑制剂相关大肠炎 (irAE大肠炎) 模仿性大肠炎,当抗药性治疗时,很难管理.
- 耐火性IRAE大肠炎的手术选择尚未得到充分确立.
研究的目的:
- 报告一种耐火性IRAE大肠炎的病例,该病例是用转向环状结肠切除术来管理的.
- 讨论手术干预在严重IRAE结肠炎中的作用.
- 为了探讨在IRAE大肠炎后恢复ICI的挑战.
主要方法:
- 一名64岁的男性患有复发性肺腺癌,在服用 pembrolizumab 后出现了严重的 irAE 大肠炎.
- 患者接受了皮质类固醇,infliximab,梅萨拉和白细胞化治疗,但没有改善.
- 由于耐火性症状和表现不佳的状态,进行了转向环结节切除术.
主要成果:
- 静脉切除术解决了腹部症状,使化疗恢复成为可能.
- 由于持续的粘膜病变,口腔闭塞是不可能的.
- 该患者后来接受了尼沃卢马布,但在手术后两年因癌症而死亡.
结论:
- 转向环结肠切除术可能是治疗耐火性IRAE大肠炎的可行选择.
- 需要进一步研究外科手术策略和IRAE结肠炎后的ICI再挑战.
- 这一案例强调了ICI诱导的胃肠道毒性的复杂管理.
相关概念视频
01:21Inflammatory Bowel Disease V: Surgical Management
433
Surgical interventions for inflammatory bowel disease (IBD), which includes ulcerative colitis and Crohn's disease, are essential in managing symptoms and addressing complications. The selection of surgical procedures is contingent upon the specific conditions and complications that stem from these illnesses.
Here are some common surgical interventions for IBD:
Here are some common surgical interventions for IBD:
433
01:29Drugs for Treatment of Ulcerative Colitis in IBD
448
Ulcerative colitis is a chronic inflammatory condition primarily affecting the colon and rectum. The primary drugs used in the treatment of ulcerative colitis are aminosalicylates. They exhibit anti-inflammatory and immunosuppressive properties. They modulate inflammatory mediators and inhibit the activity of nuclear factor κB (NF-κB). Aminosalicylates also reduce inflammation by inhibiting prostaglandin and leukotriene production and decreasing neutrophil chemotaxis and superoxide...
448
01:30Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy
626
Various diagnostic tests are employed in the diagnostic process for Inflammatory Bowel Disease (IBD), particularly to differentiate between Crohn's disease and ulcerative colitis.
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the...
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the...
626
01:29Inflammatory Bowel Disease IV: Pharmacological Management
463
Upon diagnosis, managing Inflammatory Bowel Disease (IBD) involves addressing several crucial aspects. The primary goals include resting the bowel, correcting malnutrition, and providing symptomatic relief. Resting the bowel may consist of medications to reduce inflammation and promote healing. Correcting malnutrition is essential, often requiring dietary adjustments and nutritional supplements. Symptomatic relief aims to ease pain, diarrhea, and other discomforts in IBD.
Pharmacologic...
Pharmacologic...
463
01:27Inflammatory Bowel Disease I: Ulcerative Colitis
882
Introduction
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...
882
01:30Inflammatory Bowel Disease II: Crohn's Disease
943
Introduction
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by...
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by...
943