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经皮治疗非寄生虫性脾囊肿:单疗程与多疗程治疗的长期结果

Percutaneous Treatment of Non-parasitic Splenic Cysts: Long-Term Results for Single- Versus Multiple-Session Treatment.

作者信息

Akhan Okan, Dagoglu-Kartal Merve Gulbiz, Ciftci Turkmen, Ozer Cigdem, Erbahceci Aysun, Akinci Devrim

机构信息

Department of Radiology, Hacettepe University School of Medicine, 6100, Sihhiye, Ankara, Turkey.

Department of Radiology, Istanbul University Istanbul Medical School, 34093, Çapa, Fatih, Istanbul, Turkey.

出版信息

Cardiovasc Intervent Radiol. 2017 Sep;40(9):1421-1430. doi: 10.1007/s00270-017-1650-0. Epub 2017 May 1.

Abstract

PURPOSE

The aim of this study was to investigate the efficacy and safety of percutaneous sclerotherapy for non-parasitic splenic cysts (NPSCs). The secondary aims were to introduce puncture-aspiration-injection-reaspiration (PAIR) technique in the treatment of NPSCs and to compare multiple- and single-session techniques.

MATERIALS AND METHODS

This retrospective study included 24 (17 females, 7 males) patients, treated between the years 1997 and 2015. Three techniques were used. Group A (n = 8), Group B (n = 6) and Group C (n = 10) were treated by PAIR, single-session catheterization and multiple-session catheterization, respectively. Since both PAIR and single-session catheterization techniques are carried out in a single session, Group A and Group B were evaluated in one group (Group A + B). Group A + B was compared with Group C in terms of patient demographics, the initial volume of the cysts, follow-up periods, complication and hospitalization rates and follow-up results. Recurrence and reduction rates were evaluated for two groups.

RESULTS

Technical success rate was 100%. The mean follow-up period was 68.9 months. Recurrence detected in 7 (29.1%) patients. Final reduction rate was between 40.7 and 100% (median 96.4%) with a significant difference in cyst volume (p < 0.05). There was no significant difference regarding recurrence rates (p = 1) and the final reduction rates (p = 0.51) between the two groups.

CONCLUSION

Percutaneous sclerotherapy is a minimally invasive technique, preserving maximum tissue while effectively treating NPSCs. Single-session sclerotherapy which reduces hospitalization days and increases patient comfort is as effective as multi-session sclerotherapy as the initial procedure. This study supports that single-session sclerotherapy should be a valid treatment option.

摘要

目的

本研究旨在探讨经皮硬化疗法治疗非寄生虫性脾囊肿(NPSC)的疗效和安全性。次要目的是介绍穿刺抽吸注射再抽吸(PAIR)技术在NPSC治疗中的应用,并比较多疗程和单疗程技术。

材料与方法

这项回顾性研究纳入了1997年至2015年间接受治疗的24例患者(17例女性,7例男性)。使用了三种技术。A组(n = 8)、B组(n = 6)和C组(n = 10)分别接受PAIR、单疗程导管插入术和多疗程导管插入术治疗。由于PAIR和单疗程导管插入术均在一个疗程内进行,A组和B组在一组中进行评估(A + B组)。在患者人口统计学、囊肿初始体积、随访期、并发症和住院率以及随访结果方面,将A + B组与C组进行比较。评估两组的复发率和缩小率。

结果

技术成功率为100%。平均随访期为68.9个月。7例(29.1%)患者检测到复发。最终缩小率在40.7%至100%之间(中位数为96.4%),囊肿体积有显著差异(p < 0.05)。两组之间的复发率(p = 1)和最终缩小率(p = 0.51)无显著差异。

结论

经皮硬化疗法是一种微创技术,在有效治疗NPSC的同时最大限度地保留组织。单疗程硬化疗法可减少住院天数并提高患者舒适度,作为初始治疗与多疗程硬化疗法同样有效。本研究支持单疗程硬化疗法应是一种有效的治疗选择。

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