Splanchnicectomy is a minimally invasive and effective method of treating chronic upper abdominal pain in cancer. It offers good, short-term pain relief, reduces morphine consumption, and improves patients' satisfaction. In the wake of developments in minimally invasive technology, the method has brought a number of new breakthroughs. We reviewed the effect of the success of splanchnicectomy.
Objective To evaluate the efficacy and safety of Chinese herb compared with an analgesic drug in the treatment of cancer pain. Methods We electronically searched CBM (1990 to 2008), CNKI (1990 to 2008), VIP (1990 to 2008), The Cochrane Library (Issue 3, 2008), and MEDLINE (1990 to 2008). Relevant journals and conference proceedings were also handsearched. The quality of the included trials was assessed according to the criteria recommended by the Cochrane Handbook for systematic reviews of interventions and meta-analyses were performed for homogeneous studies using the Cochrane collaboration’s review manager 4.2.2 software. Results Five randomized controlled trails (RCTs), all published in Chinese, involving 590 participants, were included. The quality of all RCTs was graded C (low). Meta-analyses were not performed due to heterogeneity. Instead, descriptive analyses were conducted. The results showed that as for the total effective rate in pain-relieving, Zhentongsan (RR=1.11, 95%CI 1.00 to 1.24, P=0.05) and Xiaozhengzhitong paste (RR=1.35, 95%CI 1.02 to 1.78, P=0.04) were more effective than Indometacin, with significant differences. There were no significant differences between Duyiwei capsule and Indometacin, and so were between Huajianbadumo as well as Shebingzhitong paste and Tramado. In terms of early potency, there were significant differences between Zhentongsan (SMD= –?9.87, 95%CI –10.84 to –8.89, Plt;0.000 01) as well as Xiaozhengzhitong paste (SMD= –8.74, 95%CI –10.164 to –7.32, Plt;0.000?01) and Indometacin, and so were between Shebingzhitong paste and Tramadol (SMD= –2.24, 95%CI –3.00 to –1.49, Plt;0.000?01). There were no significant differences between Huajianbadumo and Tramodo. With regard to the durative effect on pain-relieving, there were significant differences between Xiaozhengzhitong paste and Indometacin (WMD=4.78, 95%CI 2.99 to 6.57, Plt;0.00001), but not between Shebingzhitong paste and Tramadol. Conclusion Because of low quality of the existing studies, the current evidence is insufficient to define the efficacy and safety of compound Chinese herb, and further large-scale and high-quality RCTs are needed.
【Abstract】 Objective The effects and the complications of anhydrous alcohol intra-abdominal coeliac plexus block were studied for treating unresectable pancreatic cancer pain. Methods From Jan.2001 to Sep.2005, 61 patients with severe pancreatic cancer pain and accompanied gastrointestinal tract obstruction were treated by anhydrous alcohol intra-abdominal coeliac plexus block and palliative surgical therapy. Pain-relief, KPS and complications in 3 months after operation were observed. Results The cancer pain in all patients was controlled in one week after the block (P＜0.05). KPS was improved (P＜0.05). Three months after operation, 45(86.5%) patients were without pain or with only light pain. There were no severe complications. Conclusion Anhydrous alcohol intra-abdominal coeliac plexus block is a method with safe and good effective and less complications for the treatment of pancreatic carcinomatous pain.