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RISS 인기검색어
- 검색키워드
- 저자 : ( Kulpash Kaliaskarova ) (검색결과 2 건)
- 무료
- 기관 내 무료
- 유료
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( Kulpash Kaliaskarova ),( Yuriy Prokopenko ),( Zhansaya Muratova ),( Sergey Borovskiy ),( Tokan Sultanaliyev ),( Adilbek Mukazhanov ),( Bakhyt Zharkimbekov ),( Assan Zhexembayev ),( Gani Kuttymuratov 대한간학회 2016 춘·추계 학술대회 (KASL) Vol.2016 No.1
Aims: End-stage liver disease represents a major healthcare problem worldwide and in Kazakhstan, carrying a high risk for mortality. Around 1000 patients with end-stage liver disease need liver transplantation in Kazakhstan, more than 50 of them dying yearly without being transplanted. The aim of this paper was review treatment methods for end-stage liver cirrhosis in our center. Methods: Results of various treatment options for end-stage liver disease patients, treated in JSC National Scientific Center for oncology and transplantology since June 2013 so far, were reviewed. Results: Total of 18 liver transplantations, including 6 from cadaveric and 12 from live donors, were performed in our clinic since June 2013, so far. Etiology of liver disease was as follows: HCC (due to nonalcoholic steatohepatitis in 2, hepatitis B in 1) 3 patients, liver cirrhosis (due to alcoholic liver disease in 3, hepatitis C in 2, hepatitis B+D in 6, autoimmune hepatitis in 1, primary biliary cirrhosis in 2 and autoimmune hepatitis and hepatitis B in 1) 14 patients, remaining was 7-year old pediatric patient with biliary atresia. Out of 18 transplanted patients, 2 have succumbed in the early post-operative period due to hemorrhage, remaining 16 are followed-up, counting up to 32 months of disease and rejection-free survival. Since the establishment of hepatology beds at department of general therapy in June 2015, total of 122 patients with liver cirrhosis and hepatocellular carcinoma were treated so far up to February 2016. Methods of treatment of hepatocellular carcinoma included transarterial chemoembolisation used 10 times in 6 patients, 1 patient has succumbed after 3 months of being diagnosed. Treatment options for portal hypertension in 113 liver cirrhosis patients included: esophageal varices ligation and sclerotherapy in 45 patients, splenic artery and esophageal varices embolisation in 22 patients with no complications dated and treatment with beta blockers in the rest of the patients. Out of 113 patients, 1 has succumbed due to the disease progression since start of follow-up in June 2015. Conclusions: Liver transplantation is the only viable option for end-stage liver disease patients. Portal hypertension treatment options using endoscopic and endovascular methods may provide sufficient short-term effect with good safety profile while being waitlisted, thus making liver transplantation available for more patients.
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( Malayev Niyaz ),( Tabynbaev Nariman ),( Rutkin Igor ),( Mantas Trakimas ),( Kosyrev Vladislav ),( Kaliaskarova Kulpash ),( Borovsky Sergey ),( Dmitriyviderman ) 대한간학회 2017 춘·추계 학술대회 (KASL) Vol.2017 No.1
Aims: The purpose of the study was to highlight the results of the treatment of patients with primary and metastatic liver cancer. Methods: From November 2015 to October 2016 we performed 11 radio frequency ablation procedures for the treatment of malignant neoplasms of the liver. HCC was diagnosed in 9 (81%) patients, metastases were detected in 2 (19%) cases. The age of patients varied from 47 to 75 years and averaged 63.6 ± 7.1 years. In all cases, the liver tumors were intra-parenchymal, the tumor sizes varied from 1 to 4 cm in diameter, the maximum number of foci was 4 cm. Morphological verification of the diagnosis by percutaneous biopsy of focal liver lesions was performed in all patients using the preoperative period by ultrasound navigation. The main criterion for the radical procedure was the excess of the tumor size by the ablation zone by 1-1.5 cm on each side, which corresponds to the requirements for liver resections. In the postoperative period, the volume of destruction was determined from CT, as well as MRI with intravenous contrast. The focus of tumor tissue after RFA exposure was visualized as a weak-intensity zone without accumulation of contrast. RFA was performed intraoperatively to 1 patient, in the remaining patients it was transdermal under ultrasound control. The exposure time ranged from 12 to 36 minutes. Results: In the first two days after RFA, 5 (45%) patients had a body temperature rise up to 37.5 sС. All patients reported moderate soreness in the right hypochondrium and epigastrium during the first 3-5 days. In the early postoperative period, a transient increase in the levels of alanine aminotransferase, aspartate aminotransferase, as well as alkaline phosphatase indices on average for 7 days was noted. With control ultrasound and CT (MRI) of the liver, a decrease in the size of focal liver formations was detected, the absence of blood flow in them, the boundaries of lesions became more distinct and definite. Conclusions: RFA is the optimal method for treating patients with technically non-resectable malignant liver tumors. RFA is well tolerated by patients, has a much lower incidence of complications compared with liver resection. Perspective consideration of RFA as an integral part of combined and complex methods of treatment of liver tumors.
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