Computed Tomography-Guided Percutaneous Radiofrequency Ablation of the Splanchnic Nerves as a Single Treatment for Pain Reduction in Patients with Pancreatic Cancer
Autor: | Maria Ioannidi, Periklis Zavridis, Ioannis Kotsantis, Dimitrios Filippiadis, Stavros Grigoriadis, Maria Tsitskari, Alexis Kelekis |
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Jazyk: | angličtina |
Rok vydání: | 2021 |
Předmět: |
medicine.medical_specialty
Abdominal pain Percutaneous Radiofrequency ablation Clinical Biochemistry Analgesic Splanchnic nerves Article 030218 nuclear medicine & medical imaging law.invention 03 medical and health sciences radiofrequency 0302 clinical medicine law Pancreatic cancer medicine pain splanchnic nerves Neurolysis lcsh:R5-920 business.industry computed tomography medicine.disease Cannula Surgery neurolysis medicine.anatomical_structure medicine.symptom lcsh:Medicine (General) business 030217 neurology & neurosurgery |
Zdroj: | Diagnostics; Volume 11; Issue 2; Pages: 303 Diagnostics Diagnostics, Vol 11, Iss 303, p 303 (2021) |
ISSN: | 2075-4418 |
DOI: | 10.3390/diagnostics11020303 |
Popis: | The aim of this paper is to prospectively evaluate the efficacy and safety of percutaneous computed tomography (CT)-guided radiofrequency (RF) neurolysis of splanchnic nerves as a single treatment for pain reduction in patients with pancreatic cancer. Patients with pancreatic ductal adenocarcinoma suffering from abdominal pain refractory to conservative medication who underwent CT-guided neurolysis of splanchnic nerves by means of continuous radiofrequency were prospectively evaluated for pain and analgesics reduction as well as for survival. In all patients, percutaneous neurolysis was performed with a bilateral retrocrural paravertebral approach at T12 level using a 20 Gauge RF blunt curved cannula with a 1cm active tip electrode. Self-reported pain scores were assessed before and at the last follow-up using a pain inventory with numeric visual scale (NVS) units. The mean patient age was 65.4 ± 10.8 years (male-female: 19-11). The mean pain score prior to RF neurolysis of splanchnic nerves was 9.0 NVS units; this score was reduced to 2.9, 3.1, 3.6, 3.8, and 3.9 NVS units at 1 week, 1, 3, 6, and 12 months respectively (p < 0.001). Significantly reduced analgesic usage was reported in 28/30 patients. Two grade I complications were reported according to the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) classification system. According to the results of the present study, solely performed computed tomography-guided radiofrequency neurolysis of splanchnic nerves can be considered a safe and efficacious single-session technique for pain palliation in patients with pancreatic ductal adenocarcinoma suffering from abdominal pain refractory to conservative medication. Although effective in pain reduction the technique seems to have no effect upon survival improvement. |
Databáze: | OpenAIRE |
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