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FEATURE OncOlOgy


 Interventional procedures in oncology are not only for symptom palliation but also are therapeutic


perforation and infection. Although RIG is a straightforward procedure, complications include transgression of small and large bowel, incorrect placement of tube and peritonitis.


Hepato Biliary Commonly performed palliative biliary procedure is Percutaneous Transhepatic Cholangiography (PTC) and biliary drainage. PTC aids in delineation of level of biliary obstruction, although this would already be available to hand by non-invasive imaging such as CT and MRI. Once the level of obstruction is identified external drainage or internal- external drainage may be performed using appropriate drainage catheters. More definitive drainage is achieved by metal


stent insertion in the common bile duct. The procedure is done under conscious sedation because these are very painful. Complications include haemorrhage, infection and blockage of stents.


Urological Bladder, prostate, pelvic and other malignancies may cause ureteric obstruction, which result in hydronephrosis. This is treated by percutaneous nephrostomy and ureteric stent insertion. Nephrostomy is insertion of drain into the renal collecting system. Ureteric stents can be inserted through the same access. Occasionally these stents get blocked and require exchanges.


Vascular


In thoracic malignancies, the superior venacava (SVC) may be compressed by the lymph nodes or direct extension of the tumour causing SVC obstruction (SVCO). Reduced venous drainage from upper extremity results in facial puffiness, upper limb oedema and headaches. Stenting of SVC is performed in this situation, which relieves the patient immediately


CONCLUSION Interventional Oncology is rapidly expanding field with lots of potential to provide both therapeutic and palliative treatments to the oncology patient. ■


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 REFERENCES References available on request (magazine@informa.com)


of the symptoms. SVC stents may be place through the internal jugular or common femoral veins. Complications of this procedure include haemorrhage and migration of the stent. Any malignancy can induce thrombosis


and predispose patients to clots in the deep veins, which can result in pulmonary emboli (PE). Inferior Venacava (IVC) filters are placed in these patients to prevent PE. These are left in the patients for life and are called permanent filters. Oncology patients require long-term


venous access for chemotherapy, blood transfusion and nutrition. This is achieved by placing tunneled central venous lines and port-a-caths.


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