Radiology and Oncology最新文献

{"title":"Prevalence of diffuse idiopathic skeletal hyperostosis and association with coronary artery calcifications in Slovenia.","authors":"Vesna Lesjak, Timea Hebar, Maja Pirnat","doi":"10.2478/raon-2025-0008","DOIUrl":"10.2478/raon-2025-0008","url":null,"abstract":"<p><strong>Background: </strong>The aim of this study was to analyze the epidemiological aspects of diffuse idiopathic skeletal hyperostosis (DISH) patients in Slovenia, to evaluate the relationship between coronary CT angiography (CCTA)-derived epicardial adipose tissue (EAT) density and coronary artery calcifications (CAC) in patients with and without DISH, and study influencing factors of these parameters.</p><p><strong>Patients and methods: </strong>The research comprised patients referred for CCTA due to a clinical suspicion of coronary artery disease. DISH, CAC score and EAT attenuation were quantified using non-contrast imaging. Diagnosis of DISH was based on Resnick criteria. The CCTA was assessed for the presence of obstructive coronary artery disease (CAD). The association between DISH and the extent of CAC was explored, using correlation analysis and multivariate regression.</p><p><strong>Results: </strong>The study cohort included 219 participants. The prevalence of DISH was 7.8%. In univariate logistic regression, body mass index (BMI) (odds ratio [OR] 1.133, p = 0,005), age (OR 1.055, p = 0,032) and diabetes (OR 3.840, p = 0,015) were significantly associated with the condition. However, this association did not persist on multinomial multivariate analysis, but gender, age, hypertension and EAT attenuation were found to be significantly associated with the increasing CAC strata.</p><p><strong>Conclusions: </strong>The prevalence of DISH found is comparable with prior literature. There was no independent relationship between the prevalence of DISH and CAC. Our data point to a more nuanced and perhaps non-causal link between coronary artery disease and DISH.</p>","PeriodicalId":21034,"journal":{"name":"Radiology and Oncology","volume":"59 1","pages":"54-62"},"PeriodicalIF":2.1,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11867563/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143524243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recurrent respiratory papillomatosis: role of bevacizumab and HPV vaccination. A literature review with case presentations.","authors":"Silvio Sporeni, Francesca Rifaldi, Irene Lanzetta, Ilaria Imarisio, Benedetta Montagna, Francesco Serra, Francesco Agustoni, Paolo Pedrazzoli, Marco Benazzo, Giulia Bertino","doi":"10.2478/raon-2025-0010","DOIUrl":"10.2478/raon-2025-0010","url":null,"abstract":"<p><strong>Background: </strong>Recurrent respiratory papillomatosis (RRP) is a condition caused by human papilloma virus (HPV) infection. Curative treatments aren't identifiable, and conservative surgery is often the best option to preserve respiratory functions. To date monoclonal antibodies are considered to be a treatment choice with both good efficacy and safety profile.</p><p><strong>Materials and methods: </strong>A web-based search of MEDLINE/PubMed library from 2000 to 2024 of English-language papers was performed to identify articles by using \"respiratory or laryngeal papillomatosis\" and \"HPV respiratory infection, papillomatosis treatment, papillomatosis vaccine immunization, papillomatosis systemic treatment\". Furthermore, a manual screening of references from original articles was done to identify additional studies. We selected 34 articles.</p><p><strong>Results: </strong>Since 2009, the systemic administration of Bevacizumab has been used to treat RRP not responding to surgical treatment. The efficacy of an anti-VEGF monoclonal antibody in RRP lesions can be related to their vascular nature. The major concern is the rebound papilloma growth within the cessation of treatment. An interesting solution could be the concomitant use of immunotherapy to both reduce the burden of residual disease and activate the immune system against the HPV-infected cells.</p><p><strong>Conclusions: </strong>Bevacizumab has a safe profile with a short-term local eradication of HPV. Further prospective research with long-term follow-up is needed to better define its safety and results against the disease recurrence. Considering the role of the anti-HPV vaccine, both, in the prophylaxis of the infection and in the adjuvant setting, the actual data underline the need for evaluation of its therapeutic efficacy for the management of RRP.</p>","PeriodicalId":21034,"journal":{"name":"Radiology and Oncology","volume":"59 1","pages":"23-30"},"PeriodicalIF":2.1,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11867566/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143524159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pulsed field ablation in medicine: irreversible electroporation and electropermeabilization theory and applications.","authors":"Edward J Jacobs, Boris Rubinsky, Rafael V Davalos","doi":"10.2478/raon-2025-0011","DOIUrl":"10.2478/raon-2025-0011","url":null,"abstract":"<p><strong>Background: </strong>Focal ablation techniques are integral in the surgical intervention of diseased tissue, where it is necessary to minimize damage to the surrounding parenchyma and critical structures. Irreversible electroporation (IRE) and high-frequency IRE (H-FIRE), colloquially called pulsed-field ablation (PFA), utilize high-amplitude, low-energy pulsed electric fields (PEFs) to nonthermally ablate soft tissue. PEFs induce cell death through permeabilization of the cellular membrane, leading to loss of homeostasis. The unique nonthermal nature of PFA allows for selective cell death while minimally affecting surrounding proteinaceous structures, permitting treatment near sensitive anatomy where thermal ablation or surgical resection is contraindicated. Further, PFA is being used to treat tissue when tumor margins are not expected after surgical resection, termed margin accentuation. This review explores both the theoretical foundations of PFA, detailing how PEFs induce cell membrane destabilization and selective tissue ablation, the outcomes following treatment, and its clinical implications across oncology and cardiology.</p><p><strong>Conclusions: </strong>Clinical experience is still progressing, but reports have demonstrated that PFA reduces complications often seen with thermal ablation techniques. Mounting oncology data also support that PFA produces a robust immune response that may prevent local recurrences and attenuate metastatic disease. Despite promising outcomes, challenges such as optimizing field delivery and addressing variations in tissue response require further investigation. Future directions include refining PFA protocols and expanding its application to other therapeutic areas like benign tissue hyperplasia and chronic bronchitis.</p>","PeriodicalId":21034,"journal":{"name":"Radiology and Oncology","volume":"59 1","pages":"1-22"},"PeriodicalIF":2.1,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11867574/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143524158","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of adrenocortical carcinoma in Slovenia: a real-life analysis of histopathologic markers, treatment patterns, prognostic factors, and survival.","authors":"Urska Bokal, Jera Jeruc, Tomaz Kocjan, Metka Volavsek, Janja Jerebic, Matej Rakusa, Marina Mencinger","doi":"10.2478/raon-2025-0013","DOIUrl":"10.2478/raon-2025-0013","url":null,"abstract":"<p><strong>Background: </strong>Adrenocortical carcinoma (ACC) is a rare cancer that presents significant diagnostic and therapeutic challenges. We analyzed the management and estimated survival of ACC patients in Slovenia over a 17-year period.</p><p><strong>Patients and methods: </strong>Patients registered in the National Cancer Registry and treated from 2000 to 2017 were included. The survival and prognostic factors were assessed using the Kaplan-Meier method and Cox regression, respectively.</p><p><strong>Results: </strong>Forty-eight patients were included in our analysis. At the time of diagnosis, 6%, 42%, 25% and 27% had stage according European Network for the Study of Adrenal Tumors (ENSAT) I, II, III and IV, respectively. Adjuvant treatment with mitotane was assigned to 18 of 34 potentially eligible patients. High-risk patients treated with adjuvant mitotane showed a reduced probability of death, although the difference was not statistically significant. Relapses had numerically higher rate of R1 resection and higher Ki67. Eleven patients underwent first-line therapy with etoposide, doxorubicin, cisplatin and mitotane (EDP-M). Their median progression-free survival was 4.4 months. The median overall survival of entire cohort was 28.9 and the median disease-specific survival (DSS) was 36.2 months. The 5-year DSS rate of ENSAT I, II, III and IV were 100%, 56%, 50% and 0%, respectively. The prognostic value of ENSAT stage and Helsinki score regarding overall survival was confirmed with the multivariate analysis.</p><p><strong>Conclusions: </strong>The 5-year DSS of our ENSAT II patients was worse than reported in contemporary cohorts. Suboptimal surgery and inconsistent adjuvant therapy with mitotane might have contributed to this outcome. Better outcomes of this rare disease might be accomplished with dedicated teams including various specialties, working towards optimal staging, diagnostic and therapeutic measures.</p>","PeriodicalId":21034,"journal":{"name":"Radiology and Oncology","volume":"59 1","pages":"121-131"},"PeriodicalIF":2.1,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11867571/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143524239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interobserver and sequence variability in the delineation of pelvic organs at risk on magnetic resonance images.","authors":"Wanjia Zheng, Xin Yang, Zesen Cheng, Jinxing Lian, Enting Li, Shaoling Mo, Yimei Liu, Sijuan Huang","doi":"10.2478/raon-2025-0006","DOIUrl":"10.2478/raon-2025-0006","url":null,"abstract":"<p><strong>Background: </strong>This study evaluates the contouring variability among observers using MR images reconstructed by different sequences and quantifies the differences of automatic segmentation models for different sequences.</p><p><strong>Patients and methods: </strong>Eighty-three patients with pelvic tumors underwent T1-weighted image (T1WI), contrast enhanced Dixon T1-weighted (T1dixonc), and T2-weighted image (T2WI) MR imaging on a simulator. Two observers performed manual delineation of the bladder, anal canal, rectum, and femoral heads on all images. Contour differences were used to analyze the interobserver and intersequence variability. A single-sequence automatic segmentation network was established using the U-Net network, and the segmentation results were analyzed.</p><p><strong>Results: </strong>Variability analysis among observers showed that the bladder, rectum, and left femoral head on T1WI yielded the highest dice similarity coefficient (DSC) and the lowest 95% Hausdorff distance (HD) (all three sequences). Regarding sequence variability analysis for the same observer, the difference between T1WI and T2WI was the smallest. The DSC of the bladder, rectum, and femoral heads exceeded 0.88 for T1WI-T2WI. The differences between automatic segmentations and manual delineations were minimal on T2WI. The averaged DSC of automatic and manual segmentation of all organs on T2WI exceeded 0.81, and the averaged 95% HD value was lower than 7 mm. Similarly, the sequence variability analysis of automatic segmentation indicates that the automatic segmentation differences between T2WI and T1WI are minimal.</p><p><strong>Conclusions: </strong>T1WI and T2WI yielded better results in manual delineation and automatic segmentation, respectively. The analysis of variability among three sequences indicates that the yielded good similarity outcomes between the T1WI and T2WI cases in manual and automatic segmentation. We infer that the T1WI and T2WI (or their combination) can be used for MR-only radiation therapy.</p>","PeriodicalId":21034,"journal":{"name":"Radiology and Oncology","volume":" ","pages":"139-146"},"PeriodicalIF":2.1,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11867573/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143010033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Innovative strategies for minimizing hematoma risk in MRI-guided breast biopsies.","authors":"Michael P Brönnimann, Matthew T McMurray, Johannes T Heverhagen, Andreas Christe, Corinne Wyss, Alan A Peters, Adrian T Huber, Florian Dammann, Verena C Obmann","doi":"10.2478/raon-2025-0004","DOIUrl":"10.2478/raon-2025-0004","url":null,"abstract":"<p><strong>Background: </strong>The study aimed to investigate the reduction of hematoma risk during MRI-guided breast biopsies by evaluating position-dependent intervention parameters and characteristics of the target lesion.</p><p><strong>Materials and methods: </strong>We retrospectively analyzed 252 percutaneous MRI-guided breast biopsies performed at a single center between January 2013 and December 2023. Two groups were built depending on the severity of relative hematoma formation (using a cut-off ≤ 7.62 cm³ or > 7.62 cm³). Potential influencing variables were assessed, such as patient demographics, interventional parameters related to anatomical landmarks, and lesion characteristics. Fisher's exact test and Mann-Whitney-U-Test were used to calculate the statistical difference between groups of categorical, dichotomous, and continuous variables. Multivariable logistic regression was used to identify the strongest association with relative hematoma formation.</p><p><strong>Results: </strong>The univariate analysis showed that relatively larger hematoma occurred significantly more frequently when the patients were younger (P = 0.002), the relative distances from the target lesion to the nipple (P = 0.001) as well as alongside the access path (P = 0.001) were greater and when the vacuum-assisted biopsy system was used in contrast to the Spirotome® (P = 0.035). Multivariable logistic regression analysis also showed that these were independently associated with the occurrence of relatively larger hematomas. Epinephrine in the local anesthetic, lesion location classified by specific quadrant, and pathological findings did not influence the extent of the hematoma.</p><p><strong>Conclusions: </strong>Our findings underscore the importance of strategic procedural planning to minimize hematoma occurrence and enhance patient safety during MRI-guided breast biopsy procedures.</p>","PeriodicalId":21034,"journal":{"name":"Radiology and Oncology","volume":" ","pages":"91-99"},"PeriodicalIF":2.1,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11867564/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143010025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accuracy of transthoracic echocardiography in diagnosis of cardiac myxoma: single center experience.","authors":"Polona Kacar, Nejc Pavsic, Mojca Bervar, Zvezdana Dolenc Strazar, Katja Prokselj","doi":"10.2478/raon-2025-0007","DOIUrl":"10.2478/raon-2025-0007","url":null,"abstract":"<p><strong>Background: </strong>The differential diagnosis of cardiac myxomas (CM), the most common benign primary cardiac tumors, is broad and a thorough diagnostic workup is required to establish accurate diagnosis prior to surgical resection. Transthoracic echocardiography (TTE) is usually the first imaging modality used for diagnosis of suspected CM. In a single tertiary centre study, we sought to determine the accuracy, sensitivity, and specificity of TTE in the diagnosis of CM and to determine echocardiographic characteristics indicative of CM.</p><p><strong>Patients and methods: </strong>We retrospectively analyzed clinical, echocardiographic, and pathohistological findings of 73 patients consecutively admitted for suspected CM.</p><p><strong>Results: </strong>After diagnostic workup, 53 (73%) patients were treated surgically at our institution. Based on preoperative TTE, patients were divided into a CM group (n=45, 85%) and non-myxoma (NM) group. Of the 53 pathohistological specimens obtained during surgery, 39 (73%) were CM. The sensitivity and specificity of preoperative echocardiography were 97% and 50%, respectively. The overall accuracy was 85%. All NM tumors were found in an atypical location and 72% of CM were found in a typical position in the left atrium (p < 0.001). Tumors in NM group were significantly smaller than CM (24.3 ± 13.2 mm <i>vs</i>. 37.9 ± 18.3 mm, p = 0.017).</p><p><strong>Conclusions: </strong>Our study confirms very good accuracy of TTE in the diagnosis of CM. The most important echocardiographic characteristics to differentiate between CM and tumors of different etiology are tumor location and size. Smaller tumors presenting at an atypical location are less likely to be diagnosed as CM, and these require additional imaging modalities for accurate diagnosis.</p>","PeriodicalId":21034,"journal":{"name":"Radiology and Oncology","volume":" ","pages":"63-68"},"PeriodicalIF":2.1,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11867553/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143009478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The financial toxicity of breast cancer: a systematic mapping of the literature and identification of research challenges.","authors":"Ivica Ratosa, Mojca Bavdaz, Petra Dosenovic Bonca, Helena Barbara Zobec Logar, Andraz Perhavec, Marjeta Skubic, Katja Vörös, Ana Mihor, Vesna Zadnik, Tjasa Redek","doi":"10.2478/raon-2025-0002","DOIUrl":"10.2478/raon-2025-0002","url":null,"abstract":"<p><strong>Background: </strong>Breast cancer is one of the most common cancers, increasingly prevalent also among working-age populations. Regardless of age, breast cancer has significant direct and indirect costs on the individuals, families and society. The aim of the research was to provide a comprehensive bibliometric analysis of the financial toxicity of breast cancer, to identify research voids and future research challenges.</p><p><strong>Materials and methods: </strong>The systematic mapping of literature relied on a multi-method approach, combining bibliometric methods with a standard review/discussion of most important contributions. The analysis employed Bibliometrics in R and VosViewer.</p><p><strong>Results: </strong>The results highlighted the key authors, journals and research topics in the investigation of the financial toxicity of cancer and stressed the concentration of work around several authors and journals.</p><p><strong>Conclusions: </strong>The results also revealed a lack of a comprehensive approach in the study of financial toxicity, as the literature often focuses on one or few selected aspects of financial toxicity. In addition, geographic coverage is uneven and differences in the healthcare systems represent a challenge to straightforward comparisons.</p>","PeriodicalId":21034,"journal":{"name":"Radiology and Oncology","volume":" ","pages":"31-42"},"PeriodicalIF":2.1,"publicationDate":"2025-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11867575/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142927909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigation of <i>GSTP1</i> and <i>PTEN</i> gene polymorphisms and their association with susceptibility to colorectal cancer.","authors":"Durr-E-Shahwar, Hina Zubair, Muhammad Kashif Raza, Zahid Khan, Lamjed Mansour, Aktar Ali, Muhammad Imran","doi":"10.2478/raon-2025-0001","DOIUrl":"10.2478/raon-2025-0001","url":null,"abstract":"<p><strong>Background: </strong>This study investigates the association of single nucleotide polymorphism in glutathione S transferase P1 (rs1695 and rs1138272) and phosphatase and TENsin homolog (rs701848 and rs2735343) with the risk of colorectal cancer (CRC).</p><p><strong>Patients and methods: </strong>In this case-control study, 250 healthy controls and 200 CRC patients were enrolled. All subjects were divided into 3 groups: healthy control, patients, and overall (control + patients). Genotyping was performed using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). The demographic information, including age, gender, location, smoking status, cancer stage, and node involvement, were collected.</p><p><strong>Results: </strong>The allele frequencies of <i>PTEN</i> rs701848 in overall subjects were 0.78 for C and 0.22 for T. Similarly, in overall individuals, allele frequencies for <i>PTEN</i> rs2735343 were 0.65 and 0.35 for G and C alleles, respectively. The CC genotype or C allele of rs701848 and CG/GG genotype of rs2735343 were observed to be a risk factor for CRC. In overall individuals, a significant (p ≤ 0.05)) association was observed between rs701848 and rs2735343 polymorphisms CRC. Allele frequencies for <i>GSTP1</i> rs1695 were 0.68 and 0.32 for the A and G alleles, respectively. Allele frequencies for <i>GSTP1</i> rs1138272 were 0.68 and 0.32 for C and T alleles, respectively. However, a significant (p < 0.05) association was found in males for rs1695, while a non-significant difference was observed for the distribution of any genotypes or alleles at <i>GSTP1</i> (rs1138272).</p><p><strong>Conclusions: </strong>Both SNPs of <i>PTEN</i> rs701848 and rs2735343 polymorphisms were significantly associated with CRC. However, in <i>GSTP1</i>, rs1695 was significantly associated with CRC risk in males, and rs1138272 showed a non-significant association with colorectal cancer risk.</p>","PeriodicalId":21034,"journal":{"name":"Radiology and Oncology","volume":" ","pages":"110-120"},"PeriodicalIF":2.1,"publicationDate":"2025-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11867568/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142927908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of tramadol or topic lidocaine compared to epidural or opioid analgesia on postoperative analgesia in laparoscopic colorectal tumor resection.","authors":"Alenka Spindler-Vesel, Matej Jenko, Ajsa Repar, Iztok Potocnik, Jasmina Markovic-Bozic","doi":"10.2478/raon-2025-0003","DOIUrl":"10.2478/raon-2025-0003","url":null,"abstract":"<p><strong>Background: </strong>Chronic postoperative pain is the most common postoperative complication that impairs quality of life. Postoperative pain gradually develops into neuropathic pain. Multimodal analgesia targets multiple points in the pain pathway and influences the mechanisms of pain chronification.</p><p><strong>Patients and methods: </strong>We investigated whether a lidocaine patch at the wound site or an infusion of metamizole and tramadol can reduce opioid consumption during laparoscopic colorectal surgery and whether the results are comparable to those of epidural analgesia. Patients were randomly divided into four groups according to the type of postoperative analgesia. Group 1 consisted of 20 patients who received an infusion of piritramide. Group 2 consisted of 21 patients who received an infusion of metamizole and tramadol. Group 3 consisted of 20 patients who received patient-controlled epidural analgesia. Group 4 consisted of 22 patients who received piritramide together with a 5% lidocaine patch on the wound site. The occurrence of neuropathic pain was also investigated.</p><p><strong>Results: </strong>Piritramide consumption was significantly lowest in group 3 on the day of surgery and on the first and second day after surgery. Group 4 required significantly less piritramide than group 1 on the day of surgery and on the first and second day after surgery. The group with metamizole and tramadol required significantly less piritramide than groups 1 and 4 on the first and second day after surgery. On the day of surgery, this group required the highest amount of piritramide.</p><p><strong>Conclusions: </strong>Weak opioids such as tramadol in combination with non-opioids such as metamizole were as effective as epidural analgesia in terms of postoperative analgesia and opioid consumption. A lidocaine patch in combination with an infusion of piritramide have been able to reduce opioid consumption.</p>","PeriodicalId":21034,"journal":{"name":"Radiology and Oncology","volume":" ","pages":"132-138"},"PeriodicalIF":2.1,"publicationDate":"2025-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11867567/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142927907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}