Metastatic spinal tumors (MST) have high rates of morbidity and mortality. MST can destroy the vertebral body or compress the nerve roots, resulting in an increased risk of pathological fractures and intractable pain. Here, we elaborately reviewed the currently available therapeutic options for MST according to the following four aspects: surgical management, minimally invasive therapy (MIT), radiation therapy, and systemic therapy. In particular, these aspects were classified and introduced to show their developmental process, clinical effects, advantages, and current limitations. Furthermore, with the improvement of treatment concepts and techniques, we discovered the prevalent trend toward the use of radiation therapy and MIT in clinic therapies. Finally, the future directions of these treatment options were discussed. We hoped that along with future advances and study will lead to the improvement of living standard and present status of treatment in patients with MST.
Since the 1980s, ultrasonic diagnosis have inestimable affection on all medical domains with the development of imaging device of high discriminative ratio. Especially the appearance of intraoperative ultrasound probe recently caused the rapid development of in intraoperative ultrasound techniques. Our hospital applies high frequency probe (5.0-7.5 MHz) to abdominal hepatopancreatobiliary operation, and guild the practice of the operation. It acquired good results. Materials and methods PatientsThere are 103 patients, 68 were males and 35 were females, age ranged from 45 to 76 years (mean, 60.5 years). Hepatocellular carcinoma was 26 cases, gallbladder cancer were 5 cases, cholangiocarcinoma were 6 cases, pancreatic carcinoma were 10 cases and other 56 cases were gall stone and/or choledocholithiasis. ALOLA-1200 ultrasonography appliance with T linear array probe with the frequency of 7.5 MHz and/or the convex array probe with 5.0 MHz was used in these cases. The probe was placed for 2 h in formalin boxes before operation. Exploration of liverThe operator place the probe in the surface of liver, and explore facies diaphragmatic, visceral surface and caudal lobe orderly when the abdominal cavity was open. Then the probe could display the portal vein, bile duct and branches of hepatic vein, and minimal occult focuses in hepatic parenchyma, particularly in deep liver. Exploration of tumorsThe probe was placed in the location of lesions and explore the size of tumors, the surrounding lymph nodes, the extent of tumor infiltration, tumor thrombi of blood vessels, and the relationship between surrounding tissues and major blood vessel. With the help of this, the schedule of operation and the extent of excision was made out. Exploration the bile ductThe probe moved with the branches of bile duct to make knowledge of the dilatations of bile duct, stones and space-occupying lesions or not. It could display clearly the status of distal common bile duct and ampulla musculus sphincter when the probe was placed on the head of pancreas and/or duodenal ampulla.Abstract Objective: To explore the reference value of intraoperative ultrasonography in the operative procedure and postoperative treatment with relation to hepatopancreatobiliary surgery. Methods: 103 cases of hepatopancreatobiliary operations were collected in our hospital from January 1996 to October 2005, in which 68 cases were males and the others were females, age ranged from 45 to 76 years. Hepatocellular carcinoma were 26 cases, gallbladder carcinoma were 5 cases, cholangiocarcinoma were 6 cases, pancreatic carcinoma were 10 cases and other 56 cases were gall stone and/or choledocholithiasis. Intraoperative ultrasonography with high frequency probe was used in all cases. Results: Some minimal occult focuses was found by intraoperative ultrasonography. We found vascular tumor thrombosis in 70% cases of hepatocellular carcinomas. One case was diagnosed as pancreatic carcinoma before operation and found choledochal tract dilatation concurrently with cholangitis by int...
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