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find Keyword "姑息治疗" 3 results
  • Minimally Invasive Surgical Techniques in Obstructed Colorectal Cancer

    ObjectiveTo investigate the value of different minimally invasive surgical techniques, stent placement, laparoscopic surgery, and sustained-releasing 5-fluorouracil, in solving intestinal obstruction due to colorectal cancer. MethodsFrom May 2000 to May 2010, total 68 patients with obstructed colorectal cancers in three centers were treated in two ways in terms of the stage: The first, patients with resectable tumors underwent colorectal stent placement as a ‘bridge to surgery’ guided by enteroscope under X-ray. After clinical decompression and bowel preparation, laparoscopic radical resection was performed. The second, patients with unresectable tumors underwent rectal stent placement just for palliation. Sustained-releasing 5-fluorouracil was implanted into the local cancerous intestinal tract through stent walls. ResultsFifty-one of 52 patients underwent laparoscopic radical resection successfully following stent placement, while one failed and died during follow-up 93 d postoperatively. Forty patients with successful laparoscopic surgery were followed up in 3 to 36 months (with an average of 15 months) without tumor planting in the incision, postoperative local recurrence or anastomotic stricture. Fifteen unresectable patients and one high-risk, intolerable patient underwent rectal stent placement and implantation of sustained-releasing 5fluorouracil. During follow-up 3 to 24 months (with an average of 14 months), 11 died, who survived for (350±222) d (range 101-720 d), and 5 were still alive for 3 to 13 months (with an average of 9 months) without intestinal obstruction. ConclusionsLaparoscopic surgery combined with stent placement is an effective and safe procedure for resectable obstructed colorectal cancer. For unresectal obstructed rectal cancer, rectal stent placement combined with sustained-releasing 5-fluorouracil can prolong survival time avoiding colostomy.

    Release date:2016-09-08 10:40 Export PDF Favorites Scan
  • 胃肠吻合术联合术后化疗治疗不能根治切除伴幽门梗阻的进展期胃癌

    目的探讨不能根治性切除伴幽门梗阻进展期胃癌行胃肠吻合结合术后化疗的效果。方法选择 37 例符合纳入及排除标准的病例,进行回顾性研究,分析手术相关数据,化疗效果和生存情况。结果手术后 4 周复查胃出口梗阻评分系统(GOOSS)的评分、体质量指数(BMI)、血红蛋白及白蛋白指标,除 BMI 外,其他 3 项指标均明显好转,与术前比较差异具有统计学意义(P<0.001,P=0.027,P=0.08)。化疗后肿瘤病灶缩小 23 例(62.2%),无明显变化 11 例(29.7%),肿瘤较前增大 3 例(8.1%)。化疗后转移淋巴结缩小或消失 17 例(68.0%),6 例(24.0%)无明显变化,2 例(8.0%)淋巴结较前增大。化疗前有腹水 20 例(54.1%),化疗后腹水减少甚至消失 17 例(85.0%),腹水无明显变化 3 例(15.0%),无腹水增多者。本组 37 例患者中获随访 35 例,随访率为 94.6 %;随访时间 6~30 个月,平均 17.8 个月;本组患者的生存时间 6~30 个月,中位生存时间 11.6 个月。结论对于不能根治性切除的合并幽门梗阻的进展期胃癌,胃肠吻合术后联合化疗可获得较满意的治疗效果。

    Release date:2019-11-25 02:42 Export PDF Favorites Scan
  • Responsive neurostimulation: a new treatment option for refractory epilepsy

    Surgical removal or destruction of the focal brain area is the main treatment for drug-resistant epilepsy, but it is not suitable for all patients. Epileptiologists in the United States have opted for a new type of palliative therapy called responsive neurostimulation (RNS). The RNS system continuously monitors the electrical activity of the brain in the area of possible seizures and places electrodes in the epileptic area to provide electrical stimulation when abnormal discharges are detected, stopping seizures. Controlled clinical trials have demonstrated the long-term effectiveness and safety of the RNS system, with continued improvement in seizure reduction rates over time. RNS system not only has a good effect on temporal lobe epilepsy and cortical functional area epilepsy, but also can dynamically monitor cortical EEG, so as to better understand the epilepsy status of each patient and provide personalized diagnosis and treatment. In this paper, the development history, structure, advantages and disadvantages of RNS system are reviewed, and its indications as palliative treatment for drug-resistant epilepsy are discussed.

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