Gastroduodenal injury after radioembolization of hepatic tumors
Gastroduodenal injury after radioembolization of hepatic tumors
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DOI：
10.1111/j.1572-0241.2007.01172.x
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发表时间：
2007-06-01
影响因子：
9.8
通讯作者：
Sangro, Bruno
中科院分区：
文献类型：
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作者：
Carretero, Cristina;Munoz-Navas, Miguel;Sangro, Bruno
背景技术背景：放射性栓塞是一种新的工具，用于治疗肝肿瘤，包括在注射的生物相容性微球携带放射性同位素到肝动脉或其branchs.METHODS：我们进行了放射性栓塞78例肝肿瘤使用树脂为基础的微球负载钇-90。所有患者以前进行了评估，以尽量减少危险辐射的非靶器官的风险，并获得所需的数据剂量calculation.RESULTS：我们报告的并发症中发现的3例（3.8%），由腹痛引起的胃十二指肠病变，并有一个慢性的，阴险的过程。显微镜下，在所有受影响胃区域的标本中均检测到微球。由于这些胃十二指肠病变不出现时，nonradiating微球注射在动物中，病变很可能是由于辐射，而不是缺血性的影响血管闭塞的spheres.CONCLUSIONS：我们认为，预处理评估，包括一个更彻底的审查肝血管在寻找小的侧枝连接到胃十二指肠道，可以帮助防止这种尴尬的并发症。
BACKGROUND: Radioembolization is a new tool for the treatment of hepatic tumors that consists in the injection of biocompatible microspheres carrying radioisotopes into the hepatic artery or its branches.METHODS: We have performed radioembolization in 78 patients with hepatic tumors using resin-based microspheres loaded with yttrium-90. All patients were previously evaluated to minimize the risk of hazardous irradiation to nontarget organs and to obtain the data needed for dose calculation.RESULTS: We report a complication found in three cases (3.8%) that consists of abdominal pain resulting from gastroduodenal lesions and that had a chronic, insidious course. Microscopically, microspheres were detected in the specimens obtained from all affected gastric areas. Since these gastroduodenal lesions do not appear when nonradiating microspheres are injected in animals, lesions are likely to be due to radiation and not to an ischemic effect of vascular occlusion by spheres.CONCLUSIONS: We believe that a pretreatment evaluation that includes a more thorough scrutiny of the hepatic vascularization in search of small collaterals connecting to the gastroduodenal tract can help prevent this awkward complication.