全面性护理干预对后腹腔镜下肾肿瘤患者行肾部分切除护理的疗效分析

分析全面性护理干预对后腹腔镜下肾肿瘤患者行肾部分切除护理的疗效。方法 自2021年1月至2022年12月,本医疗机构收治了50例肾肿瘤患者,采用随机数字分配法将他们分为两组,每组各有25例。对照组采取常规护理,观察组应用全面护理干预,对比护理干预效果。结果 经过护理后发现,观察组生活质量评分高于对照组,观察组出现并发症概率低于对照组,观察组是手术情况优于对照组,P<0.05,差异具有统计学意义。结论 对于后腹腔镜下肾肿瘤患者行肾部分切除患者采取全面性护理干预,能够进一步提升护理效果,值得进行临床推广。

后腹腔镜肾部分切除术对肾肿瘤患者的临床疗效观察

分析后腹腔镜肾部分切除术对肾肿瘤患者的临床疗效。方法:以2017年1月至2018年10月在本院接受治疗的50例肾肿瘤患者为调查对象,在任意编号的方式下纳入开放组与腔镜组(n=25)。开放组实施开放性肾部分切除术,腔镜组实施后腹腔镜肾部分切除术,比较两组患者的术中出血量、肠道恢复时间、住院时间及患者并发症发生率。结果:与开放组患者相比,腔镜组患者的术中出血量、肠道恢复时间及住院时间数值均相对较低,组间差值比较具备统计学意义(p<0.05)。开放组患者并发症发生率为20%,腔镜组患者并发症发生率为4%,数据比较差异明显(p<0.05)。结论:后腹腔镜肾部分切除术治疗肾肿瘤的效果理想,患者术中出血量较少,肠道恢复时间与住院时间较短,并发症发生率较低,适合于临床推广。

Sorafenib induced tumor lysis syndrome in an advanced hepatocellular carcinoma patient

A 55-year-old male patient with hepatitis B-related liver cirrhosis was found to have advanced hepatocellular carcinoma.His AFP was initially 9828μg/L and rapidly dropped to 5597μg/L in ten days after oral sorafenib treatment.However,he developed acute renal failure, hyperkalemia,and hyperuricemia 30 d after receiving the sorafenib treatment.Tumor lysis syndrome was suspected and intensive hemodialysis was performed. Despite intensive hemodialysis and other supportive therapy,he developed multiple organ failure(liver, renal,and respiratory failure)and metabolic acidosis. The patient expired 13 d after admission.

Pancreatic metastases from renal cell carcinoma:The state of the art

Pancreatic metastases are rare,with a reported incidence varying from 1.6%to 11%in autopsy studies of patients with advanced malignancy.In clinical series,the frequency of pancreatic metastases ranges from 2%to 5%of all pancreatic malignant tumors.However,the pancreas is an elective site for metastases from carcinoma of the kidney and this peculiarity has been reported by several studies.The epidemiology,clinical presentation,and treatment of pancreatic metastases from renal cell carcinoma are known from singleinstitution case reports and literature reviews.Thereis currently very limited experience with the surgical resection of isolated pancreatic metastasis,and the role of surgery in the management of these patients has not been clearly defined.In fact,for many years pancreatic resections were associated with high rates of morbidity and mortality,and metastatic disease to the pancreas was considered to be a terminal-stage condition.More recently,a significant reduction in the operative risk following major pancreatic surgery has been demonstrated,thus extending the indication for these operations to patients with metastatic disease.

Evaluation of nephron sparing surgery for renal tumors:a single institution experience

Objective:The aim of the study was to report the experience of National Cancer Institute(NCI),Cairo University,Egypt,in managing various benign and malignant renal tumors with nephron sparing surgery(NSS),and to assess its safety and feasibility.Methods:Reviewing the literature for NSS,and records of patients who underwent NSS in the period from January 2000 to December 2009 at National Cancer Institute,Cairo University regarding the patient and tumor related characteristics,the indication for NSS,operative technique,postoperative complications,full histopathological data,and follow up results.Results:The total number of patients was 17.Mean age at surgery was 30.7 years(range 1.5-65 years).Five patients had bilateral tumors during surgery.The mean tumor size was 4.5 cm(range 1-9 cm).All patients had normal preoperative kidney functions.Seven patients had an absolute indication for NSS,6 patients had a relative indication,and 4 patients had an elective indication.All the 5 patients with bilateral tumors underwent bilateral simultaneous surgery.Cold ischemia was used in 8 patients,1 patient was exposed to warm ischemia,manual compression was used in 2 patients,and no vascular control was applied in 6 patients.Complications were encountered in 2 patients,one of them had urinary leakage which needed reoperation,and the other had subcutaneous hematoma which was treated conservatively.Histopathological analysis revealed Wilm's tumor(8 patients),angiomyolipoma(4 patients),renal cell carcinoma(4 patients),and hydatid cyst(1 patient).All patients had negative surgical margin.For patients with Wilm's tumor,the mean follow up was 21.4 months(range 0-94 months),2 patients had local recurrence,and 1 patient had distant metastasis.For patients with RCC,the mean follow up was 15.3 months(5-33 months),no patients had local recurrence or distant metastasis.All patients had normal kidney functions during postoperative and follow up periods.Conclusion:NSS is a feasible safe procedure that can be done with acceptable complications rate and it provides a good solution for patients with bilateral tumors,early localized renal cell carcinoma,and benign tumors.

The choice of the immunosuppressant for the patients of the malignant tumors after kidney transplantation

Objective: To evaluate the efficacy and safety of the immunosuppressant treatment among 10 post-renal transplantation recipients with malignant tumors. Methods: Conversion to sirolimus (SRL) treatment was performed for 10 cases which had found malignant tumors after kidney transplantation. During the follow-up period, the recurrence and diffusion of the tumor, the renal function and rejection were monitored. Results: All these cases despite the death had been followed up for at least 1 year. 9 cases had no recurrence and diffusion. 1 case died due to the tumor diffusion 7 months after the drug conversion. 1 case suffered once acute rejection 2 months after the drug conversion. This acute rejection had been inhibited by flushing dose MP. Conclusion: As a new immunosuppressant, SRL not only can prevent the generation of AR, but inhibit proliferation and development of malignant tumors in kidney transplantation recipients as well.