多学科方法应对大默克尔细胞癌围手术期治疗的挑战。

IF 1.3
Journal of cancer research and therapeutics Pub Date : 2025-04-01 Epub Date: 2025-07-05 DOI:10.4103/jcrt.jcrt_37_25
Jagdeep Sharma, Harsimran Singh Walia, Varun Saini, Arvind Guru, Lalita Gouri Mitra, Ashish Gulia
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引用次数: 0

摘要

摘要:围手术期护理的精髓在于从患者考虑手术到完全康复,以多学科团队为基础的综合方法。背部大型软组织肿块的管理是非常具有挑战性的,需要多方面的精确护理和广泛的规划。我们的病例默克尔细胞癌是这种复杂情况的一个很好的表现。多学科方法和闭环沟通对于应对以下挑战至关重要:免疫治疗及其并发症需要量身定制管理,巨大的坏死区域导致败血症,由于姿势限制导致面罩通气和插管困难,血管通路非常差,复苏需要快速输液器,心输出量和脉压变化以进行血流动力学监测。术中俯卧位与复杂整形手术重建及侧卧位拔管的挑战。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Multidisciplinary approach to the challenges in the perioperative management of large merkel cell carcinoma.

Abstract: An integrated multidisciplinary team-based approach to patients from the moment surgery is contemplated through to full recovery is the essence of perioperative care. The management of large soft tissue masses in the back is very challenging with multiple facets requiring precision care and erudite planning. Our Case of Merkel Cell carcinoma is an excellent manifestation of such a complex scenario. A multidisciplinary approach with closed-loop communication is essential in countering the challenges with the need for tailoring management for Immunotherapy and its complications, huge mass with areas of necrosis leading to sepsis, difficulty in mask ventilation and intubation due to limited posture, very poor vascular access, the need of rapid infuser for resuscitation, cardiac output and pulse pressure variation for hemodynamic monitoring, challenges with prone position intraoperatively with complex plastic surgery reconstruction and extubation in the lateral decubitus position.

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