Ablative Verfahren in der Therapie von Lebermetastasen

Abstract

ZusammenfassungWenn keine extrahepatischen Metastasen vorliegen, kann ein verbessertes Überleben mit chirurgischen und interventionellen Techniken erreicht werden. Interventionelle Techniken sind entweder definiert als perkutane oder intraoperative Laparoskopie bzw. die Anwendung von thermischer Ablation. In diesem Review konzentrieren wir uns hierbei auf die beiden etablierten Techniken der Radiofrequenzablation (RFA) und der Mikrowellenablation (MWA) zur Therapie von kolorektalen Lebermetastasen. Diese beiden Techniken erlauben eine sichere Ablation von Metastasen bis zu 3 cm Größe und haben eine niedrige Komplikationsrate. In aktuellen Leitlinien haben beide Therapien ihren Stellenwert. Im Falle von schwierig zu resezierenden Metastasen stellen sie eine gute Alternative dar. Weiterhin können sie in Kombination mit Chirurgie eingesetzt werden, um das chirurgische Trauma zu reduzieren. Bei Rezidivmetastasen kann die Durchführung einer Intervention aufgrund des operativen Traumas niedrigere Morbidität für den Patienten bedeuten. Darüber hinaus sind die interventionellen Verfahren in Kombination mit einer systemischen Therapie der alleinigen Chemotherapie überlegen.

Effect of accelerated rehabilitation nursing programmes on surgical site wound infection in patients undergoing laparoscopic cholecystectomy: A meta‐analysis

“…Consequently, accelerated rehabilitation nursing programmes have achieved remarkable results in terms of physiological and psychological well-being of patients, and relieving family pressures. 47 Our results showed that accelerated rehabilitation nursing programmes are effective in reducing the incidence of surgical site wound infections among patients undergoing LC. Compared with previous assessments, although this evaluation summarised the available evidence on the effect of accelerated rehabilitation nursing programmes on surgical site wound infection in patients undergoing LC, there are still limitations that need to be addressed: (1) The high heterogeneity of indicators affected the accuracy of the evaluation results; (2) The specific implementation measures of accelerated rehabilitation nursing programmes do not have standardised criteria.…”

“…Consequently, accelerated rehabilitation nursing programmes have achieved remarkable results in terms of physiological and psychological well‐being of patients, and relieving family pressures. 47 Our results showed that accelerated rehabilitation nursing programmes are effective in reducing the incidence of surgical site wound infections among patients undergoing LC.…”

“…The use of accelerated rehabilitation nursing principles in the treatment of hepatobiliary stone disease, which involves minimally invasive surgery, is more effective than traditional methods in patients with cancer undergoing surgical procedures, and is associated with a marked reduction in the incidence of adverse events, thereby alleviating the economic burden associated with disease treatment. Consequently, accelerated rehabilitation nursing programmes have achieved remarkable results in terms of physiological and psychological well‐being of patients, and relieving family pressures 47 . Our results showed that accelerated rehabilitation nursing programmes are effective in reducing the incidence of surgical site wound infections among patients undergoing LC.…”