Palijativna embolizacija tumora bubrega
Sažetak
Uvod/Cilj. Palijativna embolizacija tumora bubrega je metoda izbora u lečenju uznapredovalih inoperabilnih karcinoma bubrega kod bolesnika sa hematurijom i bolovima. Bolesnici sa malim tumorom na preostalom bubregu su pogodni za ovaj vid terapije, ukoliko ti bolesnici odbijaju operativni zahvat ili ukoliko tumor leži centralno, tako da operativna enukleacija nije moguća. Preduslov za uspešnu embolizaciju je kapilarna embolizacija, a glavno arterijsko stablo se zatvori metalnim spiralama. Metode. U periodu 2000–2010 godine kod 42 bolesnika urađena je palijativna embolizacija. Prosečna starost bolesnika iznosila je 75 godina. U studiju je bilo uključeno 16 žena i 26 muškaraca. Kod 8 bolesnika intervencija je ponovljena, a kod jednog, sa izraženim AV-šantovima, embolizacija je urađena četiri puta. Embolizacija je rađena alkoholom, Ivalonom 150–250 μm i metalnim spiralama. Rezultati. U toku intervencije i nakon intervencije nije bilo teških komplikacija. Ukupno 14 bolesnika još su živi, a kod umrlih prosečno preživljavanje iznosilo je 13,5 ± 10,8 meseci. Minimalno preživljavanje iznosilo je jedan mesec, a maksimalno 56 meseci. Zaključak. Naši rezultati podudaraju se sa podacima iz literature. Preživljavanje kod bolesnika bez metastaza duže je nego kod bolesnika sa metastazama, što potvrđuje i 14 bolesnika iz naše studije. Dodatnu sigurnost u terapiji malih karcinoma pruža kombinovana terapija: embolizacija i radiofrekventna termoablacija.
Ključne reči:
bubreg, neoplazme; hipernefrom; hematurija; lečenje, palijativno; embolizacija, terapijska; radiografija, interventna.Reference
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