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Title:Izolirana ekstremitetna perfuzija
Authors:ID Hočevar, Marko (Author)
Files:.pdf PDF - Presentation file, download (158,91 KB)
MD5: 7E7D97A8A75DC64C0D6D6E12EC56E9E0
PID: 20.500.12556/dirros/cdd02e82-9b2e-4d22-860e-4026d33da2a7
 
Language:Slovenian
Typology:1.04 - Professional Article
Organization:Logo OI - Institute of Oncology
Abstract:Izolirana ekstremitetna perfuzija (ILP) je oblika regionalnega zdravljenja napredovalih rakov udov. Prvič je bila opisana v 50. letih prejšnjega stoletja in se je s časom nadgrajevala. Tako so v 80. letih najprej dodali hipertermijo, v 90. letih pa še citokin TNF (tumor necrosis factor). Danes z ILP zdravimo bolnike z lokoregionalno napredovalim melanomom (intranzit zasevki) in sarkomi, pri katerih bi bila za radikalnost potrebna amputacija uda. Pri posegu izoliramo arterijo in veno za spodnji oz. zgornji ud in ju priključimo na napravo za zunajtelesni krvi obtok, s čimer ud izoliramo od sistemskega krvnega obtoka. Ud nato segrejemo na temperaturo okoli 40 o C in z izotopno metodo izključimo komunikacijo med izoliranim obtokom uda in sistemskim obtokom. Če med sistemoma ne uhaja tekočina, apliciramo citostatik. Koncentracija citostatika v izoliranem sistemu je 10- do 20-krat večja, kot je zaradi neželenih učinkov možno pri sistemski aplikaciji. Po posegu ud izperemo, zašijemo arterijo in veno ter ga znova priključimo na sistemski krvni obtok. Pooperativni zapleti so večinoma omejeni na ud in so navadno blagi (eritem in edem). Pri bolnikih z melanomom dosežemo popolni odgovor pri približno 70 % bolnikov, pri bolnikih s sarkomi pa nam omenjeni poseg omogoči ohranitev uda pri 80 % bolnikov, pri katerih bi bila sicer potrebna amputacija.
Publication status:Published
Publication version:Version of Record
Year of publishing:2010
Number of pages:str. 123-125, 168
Numbering:Letn. 14, št. 2
PID:20.500.12556/DiRROS-8822 New window
UDC:615.5-006.6-085
ISSN on article:1408-1741
URN:URN:NBN:SI:doc-ZAOMRABU
COBISS.SI-ID:1046907 New window
Copyright:by Authors
Publication date in DiRROS:31.08.2018
Views:3041
Downloads:990
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Record is a part of a journal

Title:Onkologija
Shortened title:Onkologija
Publisher:Onkološki inštitut
ISSN:1408-1741
COBISS.SI-ID:65324032 New window

Licences

License:CC BY 4.0, Creative Commons Attribution 4.0 International
Link:http://creativecommons.org/licenses/by/4.0/
Description:This is the standard Creative Commons license that gives others maximum freedom to do what they want with the work as long as they credit the author.
Licensing start date:31.08.2018

Secondary language

Language:English
Title:Isolated Limb Perfusion
Abstract:Isolated limb perfusion (ILP) is a form of regional treatment of locally advanced limb cancers. It was first described in 1950s and modified with time. In 1980s, hyperthermia was added and in 1990s TNF (tumor necrosis factor). ILP is indicated in the patients with locoregionally advanced melanoma (in transit metastases) and in the patients with limb sarcomas where amputation would be the only radical treatment. During the procedure, the artery and vein for lower/upper limb is isolated and connected to the heart-lung machine. In the first part of the procedure, the isolated limb is warming to about 40o C and leakage measurements with isotope are performed. If there is no leakage, cytotoxic drug is applied in the dosage 10-20 times higher than the maximal dosages during systemic application. At the end of the procedure, the limb is washed out and the vessels repaired. Postoperative complications are usually regional in the form of erythema and edema. ILP is an effective treatment with complete response rates reaching 70% in patients with melanoma and 80% limb sparing in patients with advanced sarcomas.


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