Flamm J, Sapik H, Glantschnig W
Urologe A. 1979 Mar;18(2):79-85.
The embolization of tumors in the treatment of hypernephromas is discussed on the basis of 13 cases. The method involved the use of three different substances: thrombin (Topostasin), homogenized muscle pulp, and fibrin from the patients own body, 600 units of thrombin being subsequently injected. In each case the embolization material was introduced into the tumorous kidney via an indwelling terminally open Kifa catheter after preoperative selective angiography. A differentiation is made in the indication between prophylactic embolization, which is performed preoperatively to prevent extensive hemorrhaging and increased tumor cell dissemination, and curative embolization applied in the case of patients presenting a greatly increased operation risk, inoperable tumor, or large-scale hematuria. The paper discusses the course of the treatment, possible complications, and postembolization in terms of case histories. The fibrin-thrombin method, beause of the small expenditure of time and technical resources involved, presently appears to be most favorable form of renal tumor embolization. Other methods are discussed on the basis of the literature.
基于13例病例讨论了肾细胞癌治疗中肿瘤的栓塞治疗。该方法使用了三种不同的物质:凝血酶(托普司他)、匀浆肌肉浆和患者自身的纤维蛋白,随后注射600单位凝血酶。在每例病例中,栓塞材料在术前选择性血管造影后通过留置的末端开放的基法导管引入患肾。在适应证方面,区分了预防性栓塞和根治性栓塞,预防性栓塞在术前进行以防止广泛出血和肿瘤细胞播散增加,根治性栓塞适用于手术风险大大增加、肿瘤无法切除或大量血尿的患者。本文根据病例史讨论了治疗过程、可能的并发症和栓塞后情况。纤维蛋白-凝血酶方法由于所需时间和技术资源较少,目前似乎是肾肿瘤栓塞最有利的形式。其他方法根据文献进行了讨论。