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预防性输尿管置管似乎可减少原发性腹膜后脂肪肉瘤切除术中的输尿管损伤。

Prophylactic Ureteral Catheter Placement Appears to Reduce Intraoperative Ureteric Injury During Resection of Primary Retroperitoneal Liposarcoma.

机构信息

26447Peking University First Hospital, Beijing, China.

594822Peking University International Hospital, Beijing, China.

出版信息

Technol Cancer Res Treat. 2022 Jan-Dec;21:15330338221087831. doi: 10.1177/15330338221087831.

Abstract

Prophylactic ureteral catheters placement (PUCP) was advocated as an effective strategy for decreasing ureteral morbidities in colorectal surgeries. However, whether it should be routinely used prior to primary retroperitoneal liposarcoma (PRLS) surgeries remains unknown. It was a retrospective study, conducted at a tertiary sarcoma center. Medical records of patients with PRLS undergoing surgeries from January 2015 through December 2018 were reviewed. Primary endpoint was the rate of ureteral morbidities during and after retroperitoneal liposarcoma resection procedures. Univariate and multivariate analyses determined risk factors associated with ureteral injury (UI) in patients undergoing surgeries. A total of 55 patients of PRLS were included. Fourteen (25.5%) patients underwent PUCP, with 1 UI (7.1%) identified. In 41 patients with no PUCP, 15 (36.6%) exhibited UIs during and post surgeries. There were significant improvements of UIs in group PUCP, compared with patients without PUCP ( < .05). Resection surgeries combined with colectomy and tumor-ureter relationship were 2 risk factors significantly associated to UIs ( < .01). PUCP might be an effective way of preventing UIs in patients with PRLS. It could be suggested especially in patients with ureter encased by tumor or anticipated colectomy during the surgical process.

摘要

预防性输尿管置管(PUCP)被认为是降低结直肠手术中输尿管并发症的有效策略。然而,在原发性腹膜后脂肪肉瘤(PRLS)手术前是否应该常规使用预防性输尿管置管还不得而知。

这是一项回顾性研究,在一家三级肉瘤中心进行。回顾了 2015 年 1 月至 2018 年 12 月期间接受手术的 PRLS 患者的病历。主要终点是腹膜后脂肪肉瘤切除过程中和之后输尿管并发症的发生率。单因素和多因素分析确定了手术患者输尿管损伤(UI)的相关危险因素。

共有 55 例 PRLS 患者纳入研究。其中 14 例(25.5%)患者接受了 PUCP,其中 1 例(7.1%)出现 UI。在未接受 PUCP 的 41 例患者中,15 例(36.6%)在手术中和手术后出现 UI。与未接受 PUCP 的患者相比,接受 PUCP 的患者 UI 显著改善(<0.05)。切除术联合结肠切除术和肿瘤与输尿管的关系是与 UI 显著相关的 2 个危险因素(<0.01)。

PUCP 可能是预防 PRLS 患者 UI 的有效方法。特别是对于术中输尿管被肿瘤包裹或预计需要结肠切除术的患者,可以建议使用预防性输尿管置管。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/775e/9047802/e8a807d8e8c7/10.1177_15330338221087831-fig1.jpg

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