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已发表论文
经 CT/超声双引导下后路椎间盘入路腹腔神经丛神经溶解术治疗上腹部癌痛的疗效及安全性：一项回顾性分析
Received 12 May 2025
Accepted for publication 7 October 2025
Published 7 November 2025 Volume 2025:18 Pages 5881—5890
DOI https://doi.org/10.2147/JPR.S529697
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Amitabh Gulati
Ling Ma,1 Ruxiang Wang,2 Lingzi Li1
1Department of Anesthesiology and Pain Research Center, Affiliated Hospital of Jiaxing University, Jiaxing, People’s Republic of China; 2Department of Anesthesiology; Fuyang Hospital of Anhui Medical University, Fuyang, People’s Republic of China
Correspondence: Ling Ma, Email 1319108@qq.com
Objective: To evaluate the effectiveness and safety of CT/ultrasound dual-modality guided posterior approach in the management of upper abdominal cancer pain.
Study Design: Clinical research study.
Methods: A total of 19 patients (7 men and 12 women) who had advanced carcinomatous epigastric pain and match the selection criteria were recruited in this study. All the patients proceed the bilateral Splanchnic Nerve Neurolysis (SNN) under Computed Tomography (CT) guided and Ultrasound. The pain Numerical Rating Scale (NRS) at different times (T0: preprocedure, T1: 1 day after-procedure, T2: 1 weeks, T3 and T4: 4 and 8 weeks after-procedure and drug taken dosages were recorded. The incidence of complications was also assessed.
Results: All the patients were successfully completed procedures under CT/Ultrasound dual-guided. NRS exhibited significant differences when comparing the preoperative time point (T0) with each of the following time intervals (T1-T4) (***P < 0.001). As the NRS gradually decreased, significant differences were observed between T2 and T3 (**P < 0.05). However, no significant difference was found between T3 and T4 regarding pain scores (p = 0.331). The consumption of morphine was significantly lower postoperatively than preoperatively, with the most pronounced reduction observed on the first day after surgery (***P < 0.001). Nevertheless, no statistically significant differences were observed at the other time intervals (P > 0.05). No severe complications during or after the surgery. Two patients (10.5%) felt burning pain in the abdomen for 2 days, 1 patient had transient backache for 3 days, and 12 (63.2%) patients had diarrhea for 1 week and disappear.
Conclusion: The CT/Ultrasound dual-guided SNN procedure is regarded as a efficacy and safety treatment for managing abdominal cancer pain. It increases constant visualization in the operation and reduces radiation exposure.
Plain Language Summary: Cancer-related abdominal pain has a significant impact on terminally ill patients, they cannot solely rely on oral medications for pain relief. Neurodestructive interventional therapy can provide a surprising solution. Due to anatomical characteristics, visceral nerve destruction is easier to perform and special recommended for patients with advanced adhesional tumors. The combined use of CT and ultrasound increases accuracy and constant observation while reducing radiation exposure, which we highly recommend.
Keywords: splanchnic nerve neurolysis (SNN), abdominal cancer pain, CT, ultrasound
1Department of Anesthesiology and Pain Research Center, Affiliated Hospital of Jiaxing University, Jiaxing, People’s Republic of China; 2Department of Anesthesiology; Fuyang Hospital of Anhui Medical University, Fuyang, People’s Republic of China
Correspondence: Ling Ma, Email 1319108@qq.com
Objective: To evaluate the effectiveness and safety of CT/ultrasound dual-modality guided posterior approach in the management of upper abdominal cancer pain.
Study Design: Clinical research study.
Methods: A total of 19 patients (7 men and 12 women) who had advanced carcinomatous epigastric pain and match the selection criteria were recruited in this study. All the patients proceed the bilateral Splanchnic Nerve Neurolysis (SNN) under Computed Tomography (CT) guided and Ultrasound. The pain Numerical Rating Scale (NRS) at different times (T0: preprocedure, T1: 1 day after-procedure, T2: 1 weeks, T3 and T4: 4 and 8 weeks after-procedure and drug taken dosages were recorded. The incidence of complications was also assessed.
Results: All the patients were successfully completed procedures under CT/Ultrasound dual-guided. NRS exhibited significant differences when comparing the preoperative time point (T0) with each of the following time intervals (T1-T4) (***P < 0.001). As the NRS gradually decreased, significant differences were observed between T2 and T3 (**P < 0.05). However, no significant difference was found between T3 and T4 regarding pain scores (p = 0.331). The consumption of morphine was significantly lower postoperatively than preoperatively, with the most pronounced reduction observed on the first day after surgery (***P < 0.001). Nevertheless, no statistically significant differences were observed at the other time intervals (P > 0.05). No severe complications during or after the surgery. Two patients (10.5%) felt burning pain in the abdomen for 2 days, 1 patient had transient backache for 3 days, and 12 (63.2%) patients had diarrhea for 1 week and disappear.
Conclusion: The CT/Ultrasound dual-guided SNN procedure is regarded as a efficacy and safety treatment for managing abdominal cancer pain. It increases constant visualization in the operation and reduces radiation exposure.
Plain Language Summary: Cancer-related abdominal pain has a significant impact on terminally ill patients, they cannot solely rely on oral medications for pain relief. Neurodestructive interventional therapy can provide a surprising solution. Due to anatomical characteristics, visceral nerve destruction is easier to perform and special recommended for patients with advanced adhesional tumors. The combined use of CT and ultrasound increases accuracy and constant observation while reducing radiation exposure, which we highly recommend.
Keywords: splanchnic nerve neurolysis (SNN), abdominal cancer pain, CT, ultrasound