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使用96%乙醇和10%盐酸米诺环素经超声引导下经皮硬化治疗先天性脾囊肿:儿科病例系列

Ultrasound-guided percutaneous sclerosis of congenital splenic cysts using ethyl alcohol 96% and minocycline hydrochloride 10%: A pediatric series.

作者信息

Accinni Antonella, Bertocchini Arianna, Madafferi Silvia, Natali Gianluigi, Inserra Alessandro

机构信息

General and Thoracic Surgery Unit, Department of Surgery, Bambino Gesù Children's Hospital, Rome.

General and Thoracic Surgery Unit, Department of Surgery, Bambino Gesù Children's Hospital, Rome.

出版信息

J Pediatr Surg. 2016 Sep;51(9):1480-4. doi: 10.1016/j.jpedsurg.2016.05.005. Epub 2016 Jun 7.

Abstract

INTRODUCTION

The management of congenital splenic cysts continues to evolve. In the past the standard treatment was splenectomy, but increased knowledge about the spleen's immunologic function has led most pediatric surgeons to preserve splenic tissue. A great number of studies using sclerosing substances have been published, but to date reports in children have been limited. Our study concerns a group of 15 children with congenital splenic cysts treated with percutaneous drainage and sclerosis with alcohol. We performed the procedure under general anesthesia and checked radiologically for possible leakage.

METHODS

In 2000 our group started managing pediatric patients with splenic cysts. During the first eight years surgery was the treatment of choice. From April 2008 to December 2014, a prospective study was conducted on 15 consecutive patients treated with percutaneous sclerotherapy. The outcomes regarding cystic dimensional variations before and after treatment were analyzed.

RESULTS

In 20% of patients complete disappearance of the cystic lesion was achieved. In 67% of the patients the maximum diameter of the cyst was reduced to below 50mm.

CONCLUSION

Our results should encourage the use of this treatment because it is a valid and safe option in childhood. The high success rate achieved with percutaneous drainage and sclerotherapy of cystic lesions supports our results.

摘要

引言

先天性脾囊肿的治疗方法不断发展。过去,标准治疗方法是脾切除术,但随着对脾脏免疫功能认识的增加,大多数小儿外科医生倾向于保留脾脏组织。已经发表了大量关于使用硬化剂的研究,但迄今为止关于儿童的报道有限。我们的研究涉及一组15例接受经皮引流及酒精硬化治疗的先天性脾囊肿患儿。我们在全身麻醉下进行该操作,并通过影像学检查是否存在渗漏。

方法

2000年我们的团队开始治疗患有脾囊肿的儿科患者。在最初的八年里,手术是首选治疗方法。从2008年4月至2014年12月,对15例连续接受经皮硬化治疗的患者进行了前瞻性研究。分析了治疗前后囊肿大小变化的结果。

结果

20%的患者囊肿病变完全消失。67%的患者囊肿最大直径缩小至50mm以下。

结论

我们的结果应鼓励采用这种治疗方法,因为它在儿童期是一种有效且安全的选择。经皮引流及硬化治疗囊肿病变所取得的高成功率支持了我们的结果。

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