Embolizacije tumora jetre – dvogodišnje iskustvo jednog centra

  • Dariusz Janczak Wroclaw Medical University, Faculty of Postgraduate Medical Training, Department of Vascular, General and Transplantation Surgery, Wroclaw, Poland
  • Dorota Zielińska 4th Military Clinical Hospital in Wroclow, Department of Surgery, Wroclaw, Poland
  • Jerzy Pawełczyk 4th Military Clinical Hospital in Wroclow, Department of Surgery, Wroclaw, Poland
  • Tadeusz Dorobisz Wroclaw Medical University, Faculty of Postgraduate Medical Training, Department of Vascular, General and Transplantation Surgery, Wroclaw, Poland
  • Jerzy Garcarek Wroclaw Medical University, Procedural Radiology and Neuroradiology, Department of General Radiology, Wroclow, Poland
  • Dariusz Patrzałek Wroclaw Medical University, Faculty of Postgraduate Medical Training, Department of Vascular, General and Transplantation Surgery, Wroclaw, Poland
  • Mariusz Chabowski Wroclaw Medical University, Faculty of Health Science, Division of Nursing in Surgical Procedures, Wroclaw, Poland
DOI: https://doi.org/10.2298/VSP170721152J
Ključne reči: jetra, neoplazme, embolizacija, terapijska, hirurgija digestivnog sistema, procedure, bleomicin

Sažetak


Apstrakt

 

Uvod/Cilj. Transkateterska arterijska hemoembolizacija (TAHE) i embolizacija portne vene (EPV) su ustanovljene metode u lečenju tumora jetre. Cilj studije bilo je prikazivanje našeg iskustva u lečenju tumora jetre, bilo kao preliminarno lečenje pre hirurškog zahvata, bilo kao deo palijativnog lečenja. Metode. Analiza je uključila 29 bolesnika kojima su učinjene 34 embolizacije. Rezultati. TAHE je učinjena kod 26 bolesnika sa hemangiomima na nepovoljnoj lokalizaciji ili kao redukcija kod inoperabilnih malignih tumora, bilo primarnih ili metastatskih. EPV je učinjena kod osam bolesnika sa primarnim tumorima jetre i metastazama u jetri iz kolona. Kod svih su tumori jetre bili inoperabilni. TAHE je učinjena kod jednog bolesnika sa hepatocelularnim karcinomom, jednog sa holangiokarcinomom, kod osam sa metastatskim tumorom, i kod 16 bolesnika sa hemangiomom. EPV je učinjena kod dva bolesnika sa holangiokarcinomom, pet bolesnika sa metastatskim tumorom i jednog sa neuroendokrinim tumorom. Kod pet bolesnika EPV embolizacija prethodila je hirurškom tretmanu, a TAHE kod šest bolesnika. Postembolizacijski sindrom je praćen kod sedam bolesnika. Smrt zbog progresije karcinoma nastupila je kod četiri EPV bolesnika i 7 TAHE bolesnika. Jedan bolesnik umro je tokom TAHE zbog hemoragijskog šoka. Zaključak. Uspešna desna PVE i selektivna TAHE su efikasne kod preliminarne pripreme bolesnika sa zdravim parenhimom jetre za opsežne resekcije jetre, ali bolesnici sa cirozom jetre zahtevaju pažljivu procenu. Kod bolesnika sa hemangiomom, embolizacija omogućava izbegavanje hirurškog zahvata zbog hirurške redukuje tumorske mase ili smanjuje opsežnost hirurškog zahvata. Preliminarni rezultati arterijske embolizacije bleomicinom pokazuju obe­ćavajuće rezultate kod gigantskih hemangima jetre.

 

 

Reference

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Objavljeno
2021/02/24
Broj časopisa
Vol. 76 Br. 7 (2019): Vojnosanit Pregled
Rubrika
Originalni članak