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放射性导向手术在肿瘤学中的新应用。

New applications of radioguided surgery in oncology.

机构信息

Department of Image, Hospital AC Camargo, São Paulo, SP, Brazil.

出版信息

Clinics (Sao Paulo). 2009 May;64(5):397-402. doi: 10.1590/s1807-59322009000500005.

DOI:10.1590/s1807-59322009000500005
PMID:19488604
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC2694242/
Abstract

OBJECTIVE

To report oncological cases (excluding those related to breast cancer) for which radioguided surgery has been used in combination with the Radioguided Occult Lesion Localization technique.

INTRODUCTION

Radioguided surgery enables a surgeon to identify lesions or tissues that have been preoperatively marked with radioactive substances. The Radioguided Occult Lesion Localization technique has been widely used to identify the sentinel lymph node and occult lesions in patients with breast cancer. However, few studies have reported the use of this technique for non-breast cancer pathologies.

METHODOLOGY

In all cases, injection of Technecium-99m sulfur colloid was performed, directly inside or near by the suspicious lesion, guided by ultrasound or computed tomography, up to 36 hours prior to the surgical procedure. Intraoperative lesion detection was carried out using a gamma-probe.

RESULTS

We report five oncology cases in which preoperative markings of the lesions were carried out using the Radioguided Occult Lesion Localization technique. The patients presented with the following: recurrence of renal cell carcinoma, cervical recurrence of papillary carcinoma of the thyroid, recurrence of retroperitoneal sarcoma, lesions of the popliteal fossa, and recurrence of rhabdomyosarcoma of a thigh. In each case, the lesions that were marked preoperatively were ultimately successfully excised.

CONCLUSIONS

Radioguided surgery has proven to be a safe and effective alternative for the management of oncology patients. The Radioguided Occult Lesion Localization technique can be useful in selected cases where suspect lesions may be difficult to identify intraoperatively, due to their dimensions or anatomical location. The procedure allows for more conservative excisions and reduces the surgery-related morbidity.

摘要

目的

报告已将放射性导向手术与放射性示踪隐匿性病灶定位技术联合应用于治疗的（不包括乳腺癌）肿瘤病例。

简介

放射性导向手术使外科医生能够识别已用放射性物质进行过术前标记的病灶或组织。放射性示踪隐匿性病灶定位技术已广泛用于识别乳腺癌患者的前哨淋巴结和隐匿性病灶。然而，鲜有研究报道该技术用于非乳腺癌病变。

方法

所有病例均在手术前 36 小时内，通过超声或计算机断层扫描，直接在可疑病灶内或附近注射锝-99m 硫胶体，进行放射性导向手术。术中使用伽马探针进行病灶探测。

结果

我们报告了 5 例肿瘤病例，这些病例均采用放射性示踪隐匿性病灶定位技术对病灶进行了术前标记。患者的情况如下：肾细胞癌复发、甲状腺乳头状癌颈部复发、腹膜后肉瘤复发、腘窝病变和大腿横纹肌肉瘤复发。在每种情况下，最终都成功地切除了术前标记的病灶。

结论

放射性导向手术已被证明是一种安全有效的治疗肿瘤患者的方法。放射性示踪隐匿性病灶定位技术可用于某些特定情况下，当由于病灶的大小或解剖位置而难以在术中识别时，该技术可能会有所帮助。该程序允许进行更保守的切除，减少与手术相关的发病率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1be2/2694242/679c7e095624/cln64_5p397f5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1be2/2694242/7627ad6a05d1/cln64_5p397f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1be2/2694242/0c6e489110d0/cln64_5p397f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1be2/2694242/11815156cdb5/cln64_5p397f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1be2/2694242/00c1ed1bafae/cln64_5p397f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1be2/2694242/679c7e095624/cln64_5p397f5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1be2/2694242/7627ad6a05d1/cln64_5p397f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1be2/2694242/0c6e489110d0/cln64_5p397f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1be2/2694242/11815156cdb5/cln64_5p397f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1be2/2694242/00c1ed1bafae/cln64_5p397f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1be2/2694242/679c7e095624/cln64_5p397f5.jpg

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