Long-term follow-up study of gastroduodenal lesions after radioembolization of hepatic tumors
Long-term follow-up study of gastroduodenal lesions after radioembolization of hepatic tumors
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DOI：
10.3748/wjg.v19.i19.2935
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发表时间：
2013-05-21
影响因子：
4.3
通讯作者：
Sangro, Bruno
中科院分区：
文献类型：
--
作者：
Rodriguez-Lago, Iago;Carretero, Cristina;Sangro, Bruno
目的：评价钇90(Y-90)球肝外栓塞继发胃十二指肠病变的长期自然史。方法：2003年9月至2012年1月，我中心共实施379例钇90树脂微球肝脏放射性栓塞术(RE)。我们回顾性地收集了我们中心进行的 379 例 RE 手术的数据。我们报告了对一系列治疗后出现胃十二指肠病变的患者进行全面的临床、分析、内镜和组织学长期随访。 结果：RE 后 12 周内，6 名患者（1.5%）出现胃肠道症状，并通过上消化道内镜检查发现胃肠道病变。 RE 与出现症状之间的平均时间为 5 周。只有一名患者需要内窥镜和手术治疗。仅使用平面图像进行治疗前评估时，胃肠道溃疡发生率为3.75%（3/80）。当同时进行单光子发射计算机断层扫描（SPECT）图像时，它减少到1%（3/299）。持续时间较长的症状为恶心、呕吐，直至治疗后25个月。结论：随访结束时所有患者均无严重症状。 SPECT 的常规使用降低了因 Y-90 颗粒意外部署而导致胃肠道病变的发生率。 (C)2013年百事登。版权所有。
AIM: To evaluate the long-term natural history of the gastroduodenal lesions secondary to extrahepatic embolization with Ytrium 90(Y-90) spheres.METHODS: From September 2003 to January 2012, 379 procedures of liver radioembolization(RE) using resin microspheres loaded with Y-90 were performed in our center. We have retrospectively compiled the data from 379 RE procedures performed in our center. We report a comprehensive clinical, analytical, endoscopic and histologic long-term follow-up of a series of patients who developed gastroduodenal lesions after the treatment.RESULTS: Six patients(1.5%) developed gastrointestinal symptoms and had gastrointestinal lesions as shown by upper endoscopy in the next 12 wk after RE. The mean time between RE and the appearance of symptoms was 5 wk. Only one patient required endoscopic and surgical treatment. The incidence of gastrointestinal ulcerations was 3.75%(3/80) when only planar images were used for the pre-treatment evaluation. It was reduced to 1%(3/299) when single-photon emission computed tomography(SPECT) images were also performed. The symptoms that lasted for a longer time were nausea and vomiting, until 25 mo after the treatment.CONCLUSION: All patients were free from severe symptoms at the end of follow-up. The routine use of SPECT has decreased the incidence of gastrointestinal lesions due to unintended deployment of Y-90 particles. (C) 2013 Baishideng. All rights reserved.