神戸大学附属図書館デジタルアーカイブ
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https://hdl.handle.net/20.500.14094/90005657
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2024-04-24
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90005657 (fulltext)
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メタデータID
90005657
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open access
出版タイプ
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タイトル
Two cases of debulking surgery for lower limb diffuse plexiform neurofibroma with transcatheter arterial embolisation
著者
Kitano, Daiki ; Osaki, Takeo ; Nakasone, Mika ; Nomura, Tadashi ; Hashikawa, Kazunobu ; Terashi, Hiroto
著者名
Kitano, Daiki
著者ID
A1544
研究者ID
1000030444582
KUID
https://kuid-rm-web.ofc.kobe-u.ac.jp/search/detail?systemId=a26aa73b7609366a520e17560c007669
著者名
Osaki, Takeo
大﨑, 健夫
オオサキ, タケオ
所属機関名
医学部附属病院
著者名
Nakasone, Mika
著者ID
A1472
研究者ID
1000030529566
KUID
https://kuid-rm-web.ofc.kobe-u.ac.jp/search/detail?systemId=c73d7c57dd9167ae520e17560c007669
著者名
Nomura, Tadashi
野村, 正
ノムラ, タダシ
所属機関名
医学部附属病院
著者ID
A1401
研究者ID
1000090403237
KUID
https://kuid-rm-web.ofc.kobe-u.ac.jp/search/detail?systemId=b0cb2d5720cb240f520e17560c007669
著者名
Hashikawa, Kazunobu
橋川, 和信
ハシカワ, カズノブ
所属機関名
医学部附属病院
著者ID
A0056
研究者ID
1000080217421
KUID
https://kuid-rm-web.ofc.kobe-u.ac.jp/search/detail?systemId=1431d96c128be803520e17560c007669
著者名
Terashi, Hiroto
寺師, 浩人
テラシ, ヒロト
所属機関名
医学部附属病院
収録物名
International Journal of Surgery Case Reports
巻(号)
55
ページ
132-135
出版者
Elsevier
刊行日
2019
公開日
2019-03-11
抄録
INTRODUCTION: Diffuse plexiform neurofibroma (DPN) in patients with neurofibromatosis type 1 (NF1) causes motility dysfunction in severe cases. Transcatheter arterial embolisation (TAE) is an effective haemorrhage control method in vascular tumour surgery. PRESENTATION OF CASE: We performed debulking surgery for DPN in the buttock and posterior thigh of two NF1 patients. Preoperative TAE with gelatine particles to tumour feeder vessels was conducted in both cases. Operative bleeding volumes were 500 and 4970 mL, respectively. In the latter case, the resection area extended to the upper poles of the buttocks, and the tumour invaded deeply into the surrounding tissues. Massive haemorrhage occurred, and internal iliac arterial balloon was inflated temporarily to further suppress the bleeding. Delayed wound healing due to TAE occurred; debridement and wound closure were required. Motor function improvement was confirmed in both patients. DISCUSSION: Bleeding volumes varied because of highly developed collateral pathways and tumour invasiveness. As the upper pole of the buttock was perfused by the superior gluteal artery and its numerous collateral vessels, complete haemostasis was difficult despite adequate TAE. Because delineating the tumour border from the normal tissue was impossible due to the high tumour invasiveness, cutting into the hypervascular tumour was inevitable. As gelatine particles were absorbed but remained within the vessels, prolonged wound ischaemia and delayed healing occurred. CONCLUSION: Although TAE with gelatine particles and balloon occlusion were reliable haemorrhage control methods in debulking surgery for lower limb DPN, optimal haemorrhage control technique, compatible with haemostasis and wound healing, was desired.
キーワード
Diffuse plexiform neurofibroma
Transcatheter arterial embolisation
Haemorrhage
カテゴリ
医学部附属病院
学術雑誌論文
権利
© 2019 The Authors. Published by Elsevier Ltd on behalf of IJS Publishing Group Ltd.
This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
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資源タイプ
journal article
言語
English (英語)
eISSN
2210-2612
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関連情報
DOI
https://doi.org/10.1016/j.ijscr.2019.01.018
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