ABSTRACT
The paper describes a case of severe complication of radio-frequency percutaneous thermoablation of renal metastasis into the liver, which occurred in a young woman with the intact cardiovascular system and manifested itself in the development of alveolar edema of the lung and acute dilation of the stomach. Pulmonary edema resulted from left ventricular myocardial and pulmonary parenchymal lesions and acute mitral valvular insufficiency. The authors' considerations as to the possible cause and mechanisms of development of this life-threatening complication first described in the literature are also given.
Subject(s)
Diathermy/adverse effects , Kidney Neoplasms/pathology , Liver Neoplasms/therapy , Mitral Valve Insufficiency/etiology , Pulmonary Edema/etiology , Acute Disease , Adult , Female , Humans , Liver Neoplasms/secondary , Lung/diagnostic imaging , Lung/pathology , Myocardium/pathology , RadiographyABSTRACT
Immediate results of 125 gastropancreatoduodenal resection (GPDR) performed for cancer of the pancreatoduodenal zone are presented. Despite extended surgery volume (15 GPDR were extended, in 14 patients resection of the major vessels was performed) postoperative lethality decreased to 1.6% due to lowered rate of severe postoperative complications (first of all insufficiency of pancreato- and biliodigestive anastomosis). Ways of prophylaxis of these complications consist in conduction of percutaneous puncture transhepatic cholangiostomy as the method of choice for billiary decompression before surgery in patients with tumor obstructive jaundice, precise surgical technique, creation of pancreatogastroanastomosis on reconstructive stage of GPDR.
Subject(s)
Attitude to Health , Bile Duct Neoplasms/surgery , Digestive System Surgical Procedures/methods , Duodenal Neoplasms/surgery , Pancreatic Neoplasms/surgery , Stomach Neoplasms/surgery , Adolescent , Adult , Aged , Female , Humans , Male , Middle AgedABSTRACT
The authors for the first time in Russia have begun serial performance of the extended GPDR. The operations were accompanied by careful morphological investigations of the removed organs and tissues. It was established that in all patients with exocrine cancer of head of the pancreas the tumor growth extended the region of the regional lymph nodes, i.e. standard GPDR in these patients oncologically could not be considered as adequate operation. Further performance of GPDR for pancreatic head exocrine cancer will expand knowledge about metastatic spread and will open opportunities to improve long-term survival of the patients with exocrine cancer of the head of the pancreas.
