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姑息性破坏性手术

[Palliative demolitive surgery].

作者信息

Caldarola L, Badellino F, Santoro L, Cardone B

出版信息

Minerva Med. 1975 May 9;66(35):1668-82.

PMID:48219
Abstract

Nine cases of untreatable tumour in which radical surgery was employed palliatively are presented. Three hemipelvectomies for recurrent rhabdomyosarcoma were performed. In one case, death occurred postoperatively, probably as a result of pulmonary embolism. One patient survived for 8 months, while the other is still alive after three years. Of two cases in which interscapulothoracic disarticulation was performed, survivals of 9 and 5 months were observed in subjects with fibrosarcoma in a mastectomy site and recurrent sarcoma of the humerus with ling metastases. Survival to 7 months was obtained in a case of sarcoma of the maxilla, while three patients with squama cell cancer of the mouth floor, chondrosarcoma of the mandible and botryoid sarcoma of the tonsillar fossa are still living after periods of 10 months to 2 yr. Though devoid of schematic indications, palliative demolition surgery can be considered in borderline cases where the operative risk is not high. Irrespective of "quantity", the "quality" of life remaining to the patients can be made compatible with the psychophysiological limits of the human personality.

摘要

本文介绍了9例采用根治性手术进行姑息治疗的无法治愈的肿瘤病例。对复发性横纹肌肉瘤进行了3例半骨盆切除术。其中1例术后死亡,可能是肺栓塞所致。1例患者存活了8个月,另1例在3年后仍然存活。在2例进行了肩胛骨胸廓离断术的病例中,乳房切除部位纤维肉瘤患者和肱骨复发性肉瘤伴肺转移患者分别存活了9个月和5个月。1例上颌骨肉瘤患者存活了7个月,而3例分别患有口底鳞状细胞癌、下颌软骨肉瘤和扁桃体窝葡萄状肉瘤的患者在10个月至2年的时间后仍然存活。尽管没有明确的适应证,但在手术风险不高的临界病例中可考虑进行姑息性切除手术。无论“数量”如何,患者剩余的“生活质量”可以与人类个性的心理生理极限相适应。

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