Alleviating Pancreatic Cancer-Associated Pain Using Endoscopic Ultrasound-Guided Neurolysis.
Alleviating Pancreatic Cancer-Associated Pain Using Endoscopic Ultrasound-Guided Neurolysis.
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DOI：
10.3390/cancers10020050
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发表时间：
2018-02-15
期刊：
影响因子：
5.2
通讯作者：
Kudo M
中科院分区：
文献类型：
--
作者：
Minaga K;Takenaka M;Kamata K;Yoshikawa T;Nakai A;Omoto S;Miyata T;Yamao K;Imai H;Sakamoto H;Kitano M;Kudo M
晚期胰腺癌患者最常见的症状是腹痛。这在传统上是用非甾体抗炎药和阿片类镇痛药治疗的。然而，这些治疗在一些患者中导致疼痛控制不足或药物相关的不良反应。一种替代的疼痛缓解方式是腹腔神经丛神经松解术，其中腹腔神经丛被化学消融。直到1996年首次描述了内镜超声（EUS）引导的腹腔神经丛松解术，该手术才在术前或术中进行。在这种经胃前入路中，在EUS引导下在腹腔干周围注射神经溶解剂。该手术作为一种微创方法获得了普及，目前广泛用于治疗胰腺癌相关疼痛。我们重点介绍两种相对较新的超声内镜引导下神经松解术：超声内镜引导下腹腔神经节神经松解术和超声内镜引导下广丛神经松解术，这两种技术的发展是为了提高疗效。尽管该技术总体上是安全有效的，但随着该手术的广泛普及，已报告了一些严重的不良事件，包括缺血性和感染性并发症。我们总结了EUS引导下胰腺癌神经松解术的临床结局（来自PubMed和Embase数据库），目的是为制定胰腺癌相关疼痛缓解策略提供有用的信息。
The most common symptom in patients with advanced pancreatic cancer is abdominal pain. This has traditionally been treated with nonsteroidal anti-inflammatory drugs and opioid analgesics. However, these treatments result in inadequate pain control or drug-related adverse effects in some patients. An alternative pain-relief modality is celiac plexus neurolysis, in which the celiac plexus is chemically ablated. This procedure was performed percutaneously or intraoperatively until 1996, when endoscopic ultrasound (EUS)-guided celiac plexus neurolysis was first described. In this transgastric anterior approach, a neurolytic agent is injected around the celiac trunk under EUS guidance. The procedure gained popularity as a minimally invasive approach and is currently widely used to treat pancreatic cancer-associated pain. We focus on two relatively new techniques of EUS-guided neurolysis: EUS-guided celiac ganglia neurolysis and EUS-guided broad plexus neurolysis, which have been developed to improve efficacy. Although the techniques are safe and effective in general, some serious adverse events including ischemic and infectious complications have been reported as the procedure has gained widespread popularity. We summarize reported clinical outcomes of EUS-guided neurolysis in pancreatic cancer (from the PubMed and Embase databases) with a goal of providing information useful in developing strategies for pancreatic cancer-associated pain alleviation.
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影响因子：
7.7
作者：
Ascunce, Gil;Ribeiro, Afonso;Levi, Joe
通讯作者：
Levi, Joe
DOI：
10.1007/s11938-017-0145-z
发表时间：
2017-09-01
期刊：
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影响因子：
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作者：
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