Onyx®,术中定位肝脏病变的新工具。

IF 1.2 4区 医学 Q3 SURGERY
Surgical Innovation Pub Date : 2024-04-01 Epub Date: 2024-02-22 DOI:10.1177/15533506241236732
J J Rubio-García, A J Mantilla Pinilla, S Gil Sánchez, C Villodre Tudela, C Alcázar López, P Melgar Requena, G Rodríguez Laiz, J Irurzun López, J M Ramia-Ángel
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引用次数: 0

摘要

背景:术前对肝脏肿瘤进行精确定位有助于手术的成功,术中超声波检查是一种敏感的成像方式。然而,术中如果出现无法触及的细小等回声包膜内病变,则可能具有挑战性:Onyx® 是一种非粘性液体制剂,由乙烯-乙烯醇组成,通常溶解在二甲基亚砜中,并悬浮微粒化的钽粉末,可在透视和超声波检查下提供对比度,并具有宏观黑色形状。这种栓塞材料越来越多地被用于颅内动静脉畸形的栓塞治疗。我们将介绍 Onyx® 在肝脏手术中的新应用:我们介绍了一例女性病例,患者 55 岁,病史显示她曾接受过一次选择性乙状结肠切除术(pT3N1a)。经过 17 个月的随访,通过 PET-CT 扫描,患者被诊断为位于第五节段的一个 13 毫米的实质性低密度小肿瘤,与转移性结直肠癌肝转移一致。术中超声检查显示病灶周围可触及高回声物质,并伴有后方声影伪影。Onyx® 是一种很有前途的新工具,以前从未在肝脏手术中应用过,但对无法触及的小肝实质内病变具有优势。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Onyx®, A New Tool for Intraoperative Localization of Liver Lesions.

Background: Precise preoperative localization of liver tumors facilitates successful surgical procedures, Intraoperative ultrasonography is a sensitive imaging modality. However, the presence of small non-palpable isoechoic intraparenchymal lesions may be challenging intraoperatively.

Methodology and material description: Onyx® is a non-adhesive liquid agent comprised of ethylene-vinyl alcohol usually used dissolved in dimethyl-sulfoxide and suspended micronized tantalum powder to provide contrast for visualization under fluoroscopy and ultrasonography and a macroscopic black shape. This embolization material has been increasingly used for the embolization of intracranial arteriovenous malformations. We present the novel application of Onyx® on liver surgery.

Current status: We present the case of a female, 55 years-old, whose medical history revealed an elective sigmoidectomy (pT3N1a). After 17 months of follow up, by PET-CT scan, the patient was diagnosed of a small intraparenchymal hypo-attenuated 13 mm tumor located at segment V consistent with metachronous colorectal liver metastasis. Open metastasectomy was performed, ultrasonography-guided Onyx® infusion was delivered the day after, intraoperative ultrasonography showed a palpable hyperechoic material with a posterior acoustic shadowing artifact around the lesion. Onyx® is a promising new tool, without any previous application on liver surgery, feasible with advantages in small not palpable intraparenchymal liver lesions.

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来源期刊
Surgical Innovation
Surgical Innovation 医学-外科
CiteScore
2.90
自引率
0.00%
发文量
72
审稿时长
6-12 weeks
期刊介绍: Surgical Innovation (SRI) is a peer-reviewed bi-monthly journal focusing on minimally invasive surgical techniques, new instruments such as laparoscopes and endoscopes, and new technologies. SRI prepares surgeons to think and work in "the operating room of the future" through learning new techniques, understanding and adapting to new technologies, maintaining surgical competencies, and applying surgical outcomes data to their practices. This journal is a member of the Committee on Publication Ethics (COPE).
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