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1.
Indian J Cancer ; 2023 Mar; 60(1): 106-113
Article | IMSEAR | ID: sea-221762

ABSTRACT

Introduction: Intrathoracic lymph node metastasis from extrathoracic neoplasms are rare. Primary malignancies that metastasize to mediastinal-hilar lymph nodes are head and neck , carcinoma breast ,and genitourinary. Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA)/endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) is currently the preferred modality for mediastinal lymph node sampling. Methods: Fifty seven patients with extrathoracic malignancies with maximum standardized uptake value (SUVmax) of mediastinal-hilar lymph nodes greater than or equal to 2.5 were taken up for EBUS-TBNA. The histo-cytopathological results obtained from EBUS-TBNA were compared with SUVmax value and short-axis diameter of a lymph node as noted on EBUS. Results: Out of 74 sampled nodes, 49 (66.2%) were benign and 25 (33.8%) were malignant. The SUVmax range of benign nodes was 2.8� as compared to 3� of malignant nodes. The size range of malignant and benign nodes were 8� mm and 8� mm, respectively. The mean size of abnormal nodes (metastatic + granulomatous) was 17.5 (8� mm) and the mean SUVmax was 9.1 (3.4�), and it was a statistically significant difference when compared to reactive (normal) nodes. At SUVmax cut-off 7.5, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) were 78.5%, 81.2%, 84.6%, and 74.2%, respectively for detecting abnormal nodes. At 13 mm size cut-off, sensitivity, specificity, PPV, NPV were 75.5%, 65%, 75%, and 72%, respectively, for detecting abnormal nodes. Conclusion: The majority of mediastinal-hilar nodes with increased metabolic activity are benign in nature. Size and SUVmax are poor predictors of metastasis in tuberculosis endemic region. There should be a restrictive attitude toward invasive diagnostic testing for mediastinal-hilar nodes in extrathoracic malignancies.

2.
Chinese Journal of Primary Medicine and Pharmacy ; (12): 1194-1198, 2023.
Article in Chinese | WPRIM | ID: wpr-991885

ABSTRACT

Objective:To investigate the clinical efficacy of ultrasound-guided closed reduction and percutaneous Kirschner wire fixation in the treatment of supracondylar fractures of the humerus in children.Methods:The clinical data of 78 children with Gartland type II and type III straight-type supracondylar fractures of the humerus who received treatment in The First Affiliated Hospital of Anhui Medical University from October 2019 to October 2022 were retrospectively analyzed. These children were divided into an observation group ( n = 38) and a control group ( n = 40) according to different treatment methods. The observation group was subjected to ultrasound-guided closed reduction and percutaneous Kirschner wire fixation. The control group was given C-arm fluoroscopy-guided closed reduction and percutaneous Kirschner wire fixation. Mayo elbow performance score (MEPS), clinical healing time, operative time, and the incidence of intraoperative complications such as vascular and nerve injury were compared between the two groups. Results:Both groups of children achieved closed reduction without open reduction. The operative time in the observation group was (30.68 ± 5.45) minutes, which was significantly shorter than (40.54 ± 5.78) minutes in the control group ( t = 2.30, P < 0.05). The healing time of the fracture in the observation and control groups was (32.73 ± 4.56) days and (36.47 ± 6.24) days, respectively, and there was no significant difference between the two groups ( P > 0.05). The range of joint motion and elbow hyperextension angle range in the observation group were (148.78 ± 3.81)° and (8.72 ± 8.92)°, respectively, and they were (147.24 ± 4.36)° and (7.98 ± 8.86)°, respectively in the control group. There were no significant differences in the range of joint motion and elbow hyperextension angle range between the two groups (both P > 0.05). The excellent and good rate of joint function in the control and observation groups was 92.5% (37/40) and 92.1% (35/38), respectively. There was no significant difference in excellent and good rate of joint function between the two groups ( P > 0.05). There were three cases of postoperative nerve damage in the control group and no vascular or nerve damage was observed in the observation group. There were significant differences in the number of cases of vascular or nerve injury between the two groups ( χ2 = 3.97, both P < 0.05). Conclusion:Ultrasound-guided closed reduction and percutaneous Kirschner wire fixation for the treatment of supracondylar fractures of the humerus can shorten the operative time, decrease the incidence of intraoperative nerve injury, and reduce the X-ray exposure time of doctors and patients.

3.
Chinese Journal of Primary Medicine and Pharmacy ; (12): 102-107, 2023.
Article in Chinese | WPRIM | ID: wpr-991715

ABSTRACT

Objective:To investigate the therapeutic effects of B ultrasound-guided extracorporeal shock wave lithotripsy combined with tamsulosin hydrochloride medication on ureteral calculi.Methods:The clinical data of 130 patients with ureteral calculi who received treatment in Ninghai First Hospital from March 2019 to June 2020 were retrospectively analyzed. These patients were divided into an observation group and a control group ( n = 65/group) according to the different treatment methods. Patients in the control group received B ultrasound-guided extracorporeal shock wave lithotripsy, and those in the observation group received B ultrasound-guided extracorporeal shock wave lithotripsy combined with tamsulosin hydrochloride medication. Total response rate, stone-free rate after the first treatment, time taken to get rid of stone, treatment times, and Visual Analogue Scale (VAS) score 14 days after the first treatment were compared between the two groups. Renal function indexes (serum creatinine, blood urea nitrogen), mean arterial pressure, VAS score, blood loss, and immunoglobulin G, immunoglobulin M, malondialdehyde, superoxide dismutase levels were determined in the two groups. Results:The total response rate in the control group was significantly lower than that in the observation group [89.23% (58/65) vs. 98.46% (64/65), χ2 = 4.80, P < 0.05]. After 14 days of treatment, the VAS score in the observation group was significantly lower than that in the control group [(3.97 ± 0.36) points vs. (5.59 ± 0.87) points, t = 13.87, P < 0.05). After treatment, the stone-free rate after the first treatment in the control group was significantly lower than that in the observation group [61.54% (40/65) vs. 78.46% (51/65), χ2 = 4.43, P < 0.05). The time taken to get rid of stone and treatment times in the control group were (18.98 ± 3.52) days and (2.53 ± 0.50) times, respectively, which were significantly higher than (12.27 ± 2.77) days and (1.64 ± 0.55) times in the observation group ( t = 12.08, 9.66, both P < 0.05). Urine Kim-1 in the observation group was significantly higher than that in the control group [(89.46 ± 42.46) mmol/L vs. (72.75 ± 17.65) mmol/L, t = 2.93, P < 0.05]. Serum creatinine and blood urea nitrogen levels in the observation group were (101.75 ± 24.53) μmol/L and (348.76 ± 29.84) μmol/L, respectively, which were significantly lower than (139.53 ± 30.56) μmol/L and (397.65 ± 35.64) μmol/L in the control group ( t = 5.82, 8.48, both P < 0.05). After 20-minutes of anesthesia induction, the mean arterial pressure in the observation group was significantly higher than that in the control group [(83.45 ± 12.65) mmHg (1 mmHg=0.133 kPa) vs . (61.68 ± 9.75) mmHg, t = -10.99, P < 0.05]. Intraoperative blood loss in the observation group was significantly lower than that in the control group [(112.65 ± 30.74) mL vs. (170.68 ± 35.67) mL, t = 9.94, P < 0.05]. Serum immunoglobulin G and malondialdehyde levels in the observation group were (8.56 ± 1.74) g/L and (7.74 ± 0.74) mol/L, respectively, which were significantly higher than (7.75 ± 1.68) g/L and (5.21 ± 0.65) mol/L in the control group ( t = 2.70, 20.71, both P < 0.05). Serum immunoglobulin M and superoxide dismutase levels in the observation group were (1.23 ± 0.32) g/L and (71.75 ± 8.57) U/L, which were significantly lower than (1.55 ± 0.45) g/L and (90.64 ± 9.73) U/mL in the control group ( t = -4.67, -11.75, both P < 0.05). Conclusion:B ultrasound-guided extracorporeal shock wave lithotripsy combined with tamsulosin hydrochloride medication is more effective on ureteral calculi than B ultrasound-guided extracorporeal shock wave lithotripsy alone. The combined therapy can effectively reduce pain, increases the treatment efficacy, and is worthy of reference and promotion in clinical practice.

4.
Journal of Southern Medical University ; (12): 122-127, 2023.
Article in Chinese | WPRIM | ID: wpr-971504

ABSTRACT

OBJECTIVE@#To assess the safety and efficacy of"leverage pry-off method"for preventing thermal injury during microwave ablation of benign thyroid nodules.@*METHODS@#From July, 2017 to September, 2019, a total of 348 patients with benign thyroid nodules underwent ultrasound-guided microwave ablation. For protecting from thermal injury during the ablation, "hydrodissection technique" was used in 174 of the patients (admitted from July, 2017 to August, 2018) and "leverage pry-off method" in the other 174 patients (admitted from September, 2018 to September, 2019). All the patients were followed up for 1 to 12 months after the operation for observation of severe complications and nodular residues.@*RESULTS@#Ultrasound-guided microwave ablation was completed in all the 348 patients. The most common severe complication associated with the ablation was voice change, occurring in 3 cases (1.7%) in "hydrodissection technique" group and in 4 (2.3%) in the "leverage pry-off method" group, showing no significant difference between the two groups (P>0.05). During the follow-up, no significant difference was found in the rate of nodular residues between the "hydrodissection technique" group and "hydrodissection technique" group (9.8% vs 10.9% (P>0.05).@*CONCLUSIONS@#The "leverage pry-off method" is simple and effective for preventing thermal injury during microwave ablation of benign thyroid nodules.


Subject(s)
Humans , Microwaves/therapeutic use , Thyroid Nodule/surgery , Burns , Hospitalization , Radiofrequency Ablation
5.
Acta Academiae Medicinae Sinicae ; (6): 366-373, 2023.
Article in Chinese | WPRIM | ID: wpr-981280

ABSTRACT

Objective To investigate the influencing factors and establish a model predicting the performance of needle visualization in fine-needle aspiration (FNA) of thyroid nodules. Methods This study prospectively included 175 patients who underwent FNA of thyroid nodules in the Department of Ultrasound in China-Japan Friendship Hospital and compared the display of the needle tips in the examination of 199 thyroid nodules before and after the application of needle visualization.We recorded the location,the positional relationship with thyroid capsule,ultrasonic characteristics,and the distribution of the soft tissue strip structure at the puncture site of the nodules with unclear needle tips display before using needle visualization.Furthermore,according to the thyroid imaging reporting and data system proposed by the American College of Radiology,we graded the risk of the nodules.Lasso-Logistic regression was employed to screen out the factors influencing the performance of needle visualization and establish a nomogram for prediction. Results The needle tips were not clearly displayed in the examination of 135 (67.8%) and 53 (26.6%) nodules before and after the application of needle visualization,respectively,which showed a significant difference (P<0.001).Based on the positional relationship between the nodule and capsule,anteroposterior/transverse diameter (A/T) ratio,blood supply,and the distribution of subcutaneous strip structure at the puncture site,a nomogram was established to predict the probability of unclear display of the needle tips after application of needle visualization.The C-index of the prediction model was 0.75 (95%CI=0.67-0.84) and the area under the receiver operating characteristic curve was 0.72.The calibration curve confirmed the appreciable reliability of the prediction model,with the C-index of 0.70 in internal validation. Conclusions Needle visualization can improve the display of the needle tip in ultrasound-guided FNA of thyroid nodules.The nomogram established based on ultrasound features such as the positional relationship between the nodule and capsule,A/T ratio,blood supply,and the distribution of subcutaneous strip structure at the puncture site can predict whether needle visualization is suitable for the examination of nodules.


Subject(s)
Humans , Thyroid Nodule/diagnostic imaging , Biopsy, Fine-Needle/methods , Reproducibility of Results , Ultrasonography , Retrospective Studies , Thyroid Neoplasms
6.
Journal of Modern Urology ; (12): 879-881, 2023.
Article in Chinese | WPRIM | ID: wpr-1005977

ABSTRACT

【Objective】 To evaluate the efficacy and safety of 3-dimensional laparoscopic pyeloplasty and ultrasound-guided flexible ureteroscopy lithotripsy (3DLP-UGFURL) in the treatment of ureteropelvic junction obstruction (UPJO) and renal calculi. 【Methods】 The clinical data of 29 patients of UPJO complicated with renal calculi treated with 3DLP-UGFURL during Dec.2017 and Jul.2022 were retrospectively analyzed. There were 23 males and 6 females with average age of (35.3±13.6) years. The lesions were on the left side in 20 cases, on the right side in 9 cases, and all were unilateral. One case was complicated with horseshoe kidney. The body mass index (BMI) was 23.6±3.9. Multiple calculi of renal pelvis or calyces occurred in 16 cases, and the rest were single calculi. The maximum diameter of calculi was (1.2±0.6)cm. There were 2 cases of mild hydronephrosis, 19 cases of moderate hydronephrosis and 8 cases of severe hydronephrosis. 【Results】 All operations were successful. The operation time of 3DLP was (84.2±15.4)min. Operation time of UGFURL was (42.8±15.7)min. Estimated blood loss was (36.9±13.6)mL. Indwelling time of drainage tube was (3.6±1.6)d. Indwelling time of urinary catheter and postoperative hospital stay was (6.8±1.2)d. One month after operation, the stone removal rate was 97.4%. The retention time of ureteral stent was 2.7 months. During the follow-up of (24.5±10.0)months, there were 45 Clavien Dindo grade 1 complications. 【Conclusion】 3DLP-UGFURL is safe and effective in the treatment of UPJO complicated with renal calculi, but it still needs long-term follow-up data.

7.
Journal of Modern Urology ; (12): 984-987, 2023.
Article in Chinese | WPRIM | ID: wpr-1005961

ABSTRACT

【Objective】 To evaluate the efficacy of ultrasound-guided transperineal puncture and drainage in the treatment of pelvic lymphatic cyst. 【Methods】 A total of 26 patients with pelvic lymphocele who failed with conservative treatment received transperineal puncture and drainage guided by rectal ultrasound. 【Results】 All operations were successful without serious complications. The symptoms in 24 patients relieved within 48 hours after catheter drainage, and 2 patients had the catheter removed after continuous drainage for 3 weeks. Of the 26 patients, 19(73.1%) were cured and 7(26.9%) were relieved. The total effective rate was 100%. 【Conclusion】 Transperineal drainage guided by rectal ultrasound is a safe and effective treatment for pelvic lymphocele.

8.
Philippine Journal of Obstetrics and Gynecology ; : 233-238, 2023.
Article in English | WPRIM | ID: wpr-1003738

ABSTRACT

@#This paper documents the first reported cases of patients in the country who underwent transvaginal ultrasound‑guided Tru‑cut biopsy of pelvic tumors in a tertiary level health institution in 2019. Different indications for Tru‑cut biopsy were demonstrated highlighting its clinical utility in the diagnosis and management of malignant pelvic tumors. All patients warranted histologic diagnosis for further planning of the most appropriate management. Adequate tissue samples were obtained from all three patients with no procedure‑related complications.

9.
Philippine Journal of Otolaryngology Head and Neck Surgery ; : 42-47, 2023.
Article in English | WPRIM | ID: wpr-1003648

ABSTRACT

Objective@#To determine the risk of malignancy of Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) indeterminate Thyroid Nodules (Bethesda III, IV and V) by combining cytologic (TSBRTC) and Thyroid Imaging Reporting and Data Systems (TI-RADS) ultrasonographic features based on final histopathology.@*Methods@#Design: Retrospective review of records. Setting: Tertiary Private Training Hospital. Participants: 551 records. @*Results@#Among 81 eligible participants, 59 out of 84 nodules (70.24%) wer malignant on histopathology. The malignancy risk of Bethesda classification was 60.87% (28 out of 46) for Bethesda III, 57.14% (8 out of 14) for Bethesda IV and 95.83% for Bethesda V. The malignancy risk for TI-RADS categories was 0 % (0/1) for TI-RADS 2, 50% (10 out of 20) for TI-RADS 3, 71.05 % for TI-RADS 4 and 91.67 % for TI-RADS 5. The highest risk of malignancy (100%) was associated with [Bethesda IV/TI-RADS 1, 2, and 3], [Bethesda V/TI-RADS 1, 2 and 3 [Bethesda IV and V/TI-RADS 1, 2 and 3] and [Bethesda IV/TI-RADS 5]. The lowest risk of malignancy (33.33%) was associated with [Bethesda III/TI-RADS1, 2 and 3]. A high Bethesda classification (Bethesda V) was almost 5x more likely to have a malignant anatomorphology compared with Bethesda III (p = .05) while a TI-RADS 4 or 5 category was almost 5x more likely to have a malignant anatomorphology compared to TI-RADS 1, 2 or 3 (p = .026).@*Conclusion@#This study showed that TI-RADS scoring is a sensitive diagnostic classification in recognizing patients with thyroid cancer and combining Bethesda classification and TI-RADS scoring increases the sensitivity in the diagnosis of malignant thyroid nodules. A higher likelihood of malignancy is associated with higher Bethesda classification and TI-RADS scoring.


Subject(s)
Thyroidectomy
10.
Chinese Journal of Digestive Endoscopy ; (12): 379-384, 2023.
Article in Chinese | WPRIM | ID: wpr-995394

ABSTRACT

Objective:To compare the safety and efficacy of endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) for the treatment of biliary obstruction at different locations.Methods:From January 2016 to June 2021 data of 82 patients with obstructive jaundice treated with EUS-HGS in Nanjing Drum Tower Hospital were reviewed in this retrospective cohort study. According to the location of biliary obstruction,patients were divided into hilar biliary obstruction group ( n=30) and distal biliary obstruction group ( n=52). Univariate and multivariate logistic regression analyses were conducted adjusting covariates to compare the technical success rate, the clinical success rate, the adverse reaction incidence, hospital stay and cost of the two groups. Results:The technical success rates were 93.3% (28/30) and 94.2% (49/52) in the hilar biliary obstruction group and the distal biliary obstruction group with no significant difference between the two groups ( P=0.870, OR=1.17, 95% CI: 0.18-7.41). The clinical success rates were 83.3% (25/30) and 88.5% (46/52) in the hilar biliary obstruction group and the distal biliary obstruction group with no significant difference between the two groups ( P=0.514, OR=1.53, 95% CI: 0.43-5.53). The incidence of adverse events in hilar biliary obstruction group was 10.0% (3/30), including cholangitis 3.3% (1/30), biliary fistula 6.7% (2/30), biliary peritonitis 6.7% (2/30). The incidence of adverse events in patients with distal biliary obstruction was 17.3% (9/52), including cholangitis 9.6% (5/52), biliary fistula 7.7% (4/52) and biliary peritonitis 5.8% (3/52). There was no significant difference in the incidence of adverse events between the two groups ( P>0.05). Conclusion:There is no significant difference in safety or efficacy of EUS-HGS for hilar biliary obstruction and distal biliary obstruction.

11.
Chinese Journal of Digestive Endoscopy ; (12): 365-371, 2023.
Article in Chinese | WPRIM | ID: wpr-995392

ABSTRACT

Objective:To explore the feasibility of smart phone real-time picture exchange-assisted telecytopathology for rapid on-site evaluation (tele-ROSE), and the role of tele-ROSE in improving the diagnostic efficiency of endoscopic physicians.Methods:Data of patients who underwent endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) from April 2020 to May 2021 in Qilu Hospital of Shandong University were retrospectively collected. Patients who didn't receive ROSE from April 2020 to October 2020 were enrolled in the non-ROSE group, and those who underwent ROSE from November 2020 to May 2021 were enrolled in the ROSE group, of which endosonographers used WeChat on the smartphone to send ROSE images to cytopathologists from November 2020 to March 2021 were the mobile phone group, and those whose ROSE results independently diagnosed by trained endosonographers from April 2021 to May 2021 were the self-ROSE group. Basic information, ROSE results, postoperative pathology and follow-up were compared, and the diagnostic effectiveness of tele-ROSE was analyzed.Results:A total of 188 cases were included, of which 179 cases (95.2%) were solid pancreatic lesions and 9 (4.8%) were enterocoelia lesions. There was no significant difference in the puncture time among the non-ROSE, mobile phone and self-ROSE groups [3 (3, 4) VS 3 (3, 4) VS 3 (2, 4), H=1.320, P=0.517]. With the final diagnosis as the golden standard, the sensitivity, the specificity, the accuracy, the positive predictive value, the negative predictive value and Kappa value of the non-ROSE group were 80.6% (58/72), 89.5% (17/19), 82.4% (75/91), 96.7% (58/60), 54.8% (17/31), and 0.6 respectively. The corresponding indices in the ROSE group were 97.4% (74/76), 100.0% (21/21), 97.9% (95/97), 100.0% (74/74), 91.3% (21/23), and 0.9 respectively, those of the mobile phone group were 95.2% (40/42), 100.0% (10/10), 96.2% (50/52), 100.0% (40/40), 83.3% (10/12), and 0.9 respcetively, and those of the self-ROSE group were 100.0% (34/34), 100.0% (11/11), 100.0% (45/45), 100.0% (34/34), 100.0% (11/11), and 1.0 respectively. The sensitivity ( P=0.002), the accuracy ( P=0.001) and the negative predictive value ( P=0.009) of the ROSE group were significantly higher than those of the non-ROSE group, and there was no significant difference in other diagnostic efficacy indices ( P>0.05). There was no significant difference between the mobile phone group and the self-ROSE group in diagnostic efficacy ( P>0.05). Conclusion:Instant smartphone-assisted tele-ROSE through WeChat can well meet the needs of pathologists and endoscopic physicians. After the application of tele-ROSE training, the diagnostic accuracy of endoscopic physicians is equivalent to that of cytopathologist, which helps to obtain more sufficient specimens under endoscopy and improve the diagnostic accuracy of EUS-FNA.

12.
Ann Card Anaesth ; 2022 Dec; 25(4): 447-452
Article | IMSEAR | ID: sea-219254

ABSTRACT

Background:Ultrasound?guided (USG) radial artery cannulation against the standard palpation technique increases the first attempt rate in both pediatric and adult patients. The objective of this study was to evaluate the benefits of USG versus the palpation technique in improving the first attempt rate in elderly patients. Methods: The patients over 65 years of age were randomized to the USG or Palpation group. The radial artery identification in the USG group was performed with the aid of the Sonimage HS 1. In the Palpation group, the radial artery was identified by manual palpation. The operators were cardiothoracic anesthesiologists. Overall success was defined as cannulation completed within 10 min. Results: Eighty patients (40 in each group) were recruited. The respective first attempt and overall success rate for the USG group were similar to the Palpation group (P > 0.999 and P = 0.732). The time to the first attempt and overall success were also similar (P = 0.075 and P = 0.636). The number of attempts, number of catheters used, and failure rates were similar between the groups (P = 0.935, P = 0.938, and P = 0.723). The number of successful cannulations within 10 min was similar for both the groups as categorized by the radial artery diameter (P = 0.169). Conclusions: The USG did not increase the first attempt or overall success rate of radial artery cannulation in the elderly patients undergoing cardiothoracic surgery. The time to first attempt and overall success were similar between both the groups. The number of attempts and number of catheters used were similar between both groups.

13.
Rev. colomb. anestesiol ; 50(4): e202, Oct.-Dec. 2022. tab, graf
Article in English | LILACS | ID: biblio-1407946

ABSTRACT

Abstract Introduction: Inadequate pain control after major surgery can lead to significant complications. Ultrasound (US) guided plane blocks account for significant progress in regional anesthesia. Objective: This study explored the analgesic superiority of ultrasound-guided erector spinae (ESPB) and transversus abdominis (TAPB) plane blocks in patients undergoing major ovarian cancer surgery under general anesthesia. There have been no previous studies comparing their efficacy under these circumstances. Methods: This double-blind randomized comparative study included 60 patients undergoing major ovarian cancer surgery under general anesthesia. The ESPB group (n=30), received preoperative ultrasound-guided ESPB and the TAPB group (n=30), received preoperative low TAPB. Opioid consumption, HR, MAP, visual analogue scale (VAS) and adverse events were documented over 24 hours after surgery. Results: There was a highly significant difference in tramadol consumption between the two groups, with (95% CI: 16.23 to 50.43) and (95% CI: 59.23 to 95.43) for ESPB and TAPB groups, respectively. A significant difference (P < 0.01) was shown in intraoperative fentanyl consumption with (95% CI: 113 to 135.6) and (95% CI: 141.8 to 167.6) for ESPB and TAPB groups, respectively. A highly significant longer time to first analgesic request was recorded in the ESPB group (95% CI: 5.5 -15.3) (P < 0.001). VAS had a median of 2 (1-3) and 4 (2-6) for ESPB and TAPB groups, respectively, with F(1)=18.15, P=0.001 between groups. Postoperative HR and MAP in the TAPB group were significantly higher with more incidence of PONV. Conclusions: ESPB provided a more reliable analgesia versus TAPB in patients undergoing ovarian cancer surgery.


Resumen Introducción: El control inadecuado del dolor posterior a cirugía mayor puede generar complicaciones importantes. El bloqueo de los planos guiado por ecografía representa un avance significativo en anestesia regional. Objetivo: En el presente estudio se explora la superioridad analgésica de los bloqueos guiados por ecografía del plano erector de la espina (BPEE) y del plano transverso abdominal (BPTA) en pacientes sometidas a cirugía de cáncer de ovario bajo anestesia general. No se han hecho estudios previamente que comparen su eficacia bajo tales circunstancias. Métodos: Este estudio doble ciego, aleatorizado, comparativo, incluyó a 60 pacientes sometidas a cirugía mayor por cáncer de ovario, bajo anestesia general. El grupo del BPEE (n=30), recibió un BPEE guiado por ecografía, mientras que el grupo de BPTA (n=30), recibió un BPTA preoperatorio bajo. El consumo de opioides, la FC, la PAM, la escala visual analógica (EVA) y los eventos adversos, se documentaron durante las 24 horas posteriores a la cirugía. Resultados: Hubo una diferencia estadísticamente significativa en el consumo de tramadol entre los dos grupos, con un IC del 95% de 16,23 a 50,43 y un IC del 95% de 59,23 a 95,43 para los grupos de BPEE y de BPTA respectivamente. Se demostró una diferencia estadísticamente significativa (P < 0,01) en el consumo de fentanilo con un IC del 95%: 113 a 135,6 y un IC de 95%: 141,8 a 167,6 para los grupos de BPEE y BPTA, respectivamente. El tiempo transcurrido hasta la primera solicitud de analgésico en el grupo de BPEE fue significativamente más prolongado (IC 95%: 5,5 -15,3) (P < 0,001). La escala visual analógica - EVA - tuvo una mediana de 2 (1-3) y 4 (2-6) para los grupos del BPEE y BPTA, respectivamente, con F(1)=18,15, P=0,001 entre grupos. La FC y la PAM postoperatorias en el grupo de BPTA fueron significativamente superiores, con una mayor incidencia de nausea y vómito postoperatorios. Conclusiones: El BPEE proporcionó una analgesia más confiable que BPTA, en pacientes sometidas a cirugía de cáncer de ovario.

14.
Rev. bras. med. esporte ; 28(5): 592-594, Set.-Oct. 2022. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1376669

ABSTRACT

ABSTRACT Introduction: The ankle joint is the most load-bearing joint of the human body. The health consciousness of people is increasing day by day, the probability of ankle sports injuries is also increasing. Objective: Analyze the applying sports medicine ultrasound value to rehabilitate anterior talofibular tendon injury. Methods: Seventy- two patients with anterior talofibular injury in a particular hospital were divided into control and observation groups to observe the effect of recovery, recovery time, and degree of ligament injury during rehabilitation treatment. Results: In the observation group, the complete recovery rate was 91.67%, incomplete recovery (8.33%), recovery time was (2.36±0.9) months. The complete recovery rate of the control group is (77.78%), the incomplete recovery (22.2%), the recovery time (3.58±0.42) months. Patients in the experimental group had a higher grade of ligament injury III than those in the control group during each rehabilitation period; the difference was statistically significant (P<0.05). Conclusions: Sports medical ultrasound can determine the degree of anterior talofibular ligament rupture after injury, providing a basis for the clinical formulation of the treatment plan. Evidence Level II; Therapeutic Studies - Investigating the result.


RESUMO Introdução: A articulação do tornozelo é a articulação do corpo humano que mais suporta carga. A consciência da saúde das pessoas está aumentando de dia para dia, a probabilidade de lesões esportivas no tornozelo também está aumentando. Objetivo: Analisar o valor de aplicação do ultra-som de medicina esportiva para a reabilitação de lesão no tendão talofibular anterior. Métodos: Setenta e dois pacientes com lesão talofibular anterior em um determinado hospital foram divididos em grupos de controle e observação para observar o efeito da recuperação, o tempo de recuperação e o grau de lesão ligamentar durante o tratamento da reabilitação. Resultados: No grupo de observação, a taxa de recuperação completa foi de 91,67%, a recuperação incompleta (8,33%), o tempo de recuperação foi de (2,36±0,9) meses. A taxa de recuperação completa do grupo de controle é de (77,78%), a recuperação incompleta (22,2%), o tempo de recuperação (3,58±0,42) meses. Os pacientes do grupo experimental tiveram maior grau de lesão ligamentar III do que os do grupo controle durante cada período de reabilitação, a diferença foi estatisticamente significativa (P<0,05). Conclusões: A ultra-sonografia médica esportiva pode determinar o grau de ruptura do ligamento talofibular anterior após a lesão, fornecendo uma base para a formulação clínica do plano de tratamento. Nível de evidência II; Estudos Terapêuticos - Investigação de Resultados.


RESUMEN Introducción: La articulación del tobillo es la que más carga soporta del cuerpo humano. La conciencia de la salud de las personas aumenta día a día, la probabilidad de lesiones deportivas en el tobillo también aumenta. Objetivo: Analizar el valor de la aplicación de ultrasonidos en medicina deportiva para la rehabilitación de la lesión del tendón talofibular anterior. Métodos: Setenta y dos pacientes con lesión talofibular anterior en un hospital particular fueron divididos en grupos de control y de observación para observar el efecto de la recuperación, el tiempo de recuperación y el grado de lesión del ligamento durante el tratamiento de rehabilitación. Resultados: En el grupo de observación, la tasa de recuperación completa fue del 91,67%, la recuperación incompleta (8,33%), el tiempo de recuperación fue de (2,36±0,9) meses. La tasa de recuperación completa del grupo de control fue (77,78%), la recuperación incompleta (22,2%), el tiempo de recuperación (3,58±0,42) meses. Los pacientes del grupo experimental tuvieron un mayor grado de lesión del ligamento III que el grupo de control durante cada periodo de rehabilitación, la diferencia fue estadísticamente significativa (P<0,05). Conclusiones: La ecografía médico-deportiva puede determinar el grado de rotura del ligamento talofibular anterior tras la lesión, proporcionando una base para la formulación clínica del plan de tratamiento. Nivel de evidencia II; Estudios terapéuticos - Investigación de resultados.

15.
Chinese Journal of Urology ; (12): 272-278, 2022.
Article in Chinese | WPRIM | ID: wpr-933211

ABSTRACT

Objective:To discuss the clinical experience and efficacy of minimally invasive anterograde multiple endoscopic treatment of upper urinary tract stones in allograft kidney.Methods:We retrospectively analyzed 14 patients with upper urinary tract stones in allograft kidney admitted to our hospital from June 2018 to August 2020. 8 cases were female and 6 cases were male, with an average age of 47.3±11.1 years. 3 patients had hyperuricemia and four had hypertension and diabetes. The history of renal transplantation was over ten years in 3 cases, three to five years in 4 cases, two years in 3 cases, 1 year in 3 cases, and 4 months in 1 case. 3 patients had a history of RIRS, and the operation was terminated due to severe ureteral tortuosity resulting in failure of sheathing or ureteroscopy. Ureteral stent was performed in 2 cases due to stone obstruction and hydronephrosis. Serum creatinine was normal in 7 patients before operation, and serum creatinine was 91-139μmol/L in 4 patients in the compensatory stage of chronic renal insufficiency. The serum creatinine was 292, 544 and 708μmol/L respectively in 3 patients in the decompensated stage of chronic renal insufficiency or renal failure stage. The preoperative average hemoglobin was 117.5g/L. 3 cases were partial staghorn calculi, 4 cases were single caliceal or renal pelvis calculi, 2 cases were renal pelvis or caliceal calculi with upper ureteral calculi, and 5 cases were renal pelvis or renal caliceal calculi with multiple calculi. Stone size were 1 case of single upper caliceal stone of 0.7cm, 3 cases of lower caliceal stones of 1.5, 1.6 and 2.0cm, 1 case of renal pelvic stone of 1.5cm, 2 cases of middle and upper caliceal stones of 2.8 and 3.1cm, 2 cases of middle and lower caliceal stones of 1.5 and 3.2cm, respectively. 3 cases of middle upper caliceal and renal pelvic stones were 2.2, 2.5 and 2.6cm. 2 cases of renal pelvis with upper ureteral stones were 1.3 and 1.7cm, 0.7 and 0.5cm respectively. Preoperative routine urine examination showed that 9 cases had urinary tract infection, among which 5 cases had positive urine culture. Surgery was performed after therapeutic improvement with sensitive antibiotics. According to the size and distribution of stone, the combination of single access or multi-access PCNL in different diameters was adopted, supplemented by FURS. Surgical methods selection and performance: 2 cases performed in single S-PCNL with stone size were 2.2cm and 2.6cm, 2 cases performed in single M-PCNL with stone size were 1.5cm and 1.5cm, 1 case performed in Needle-perc with stone size was 0.7cm, 2 cases performed in S-PCNL combined M-PCNL with stone size were 2.8cm and 3.1cm, 3 cases performed in S-PCNL combined Needle-perc with stone size were 2.0cm, 2.5cm and 3.2cm, 2 cases performed in M-PCNL combined Needle-perc with stone size were 1.5cm and 1.6cm, 2 cases performed in S-PCNL combined anterograde FURS with stones size were 1.3cm and 1.7cm in allograft kidney and ureter stone were 0.7cm and 0.5cm, a total of 7 kinds of way, and postoperative stone free rate, laboratory indexes (serum creatinine, blood hemoglobin), surgical complications, postoperative hospital stay were analyzed.Results:All 14 patients (mean age was 47.3±11.1 years) were successfully operated. Postoperative examination revealed 1 case had 0.6cm residual stone and it was cleared at the second stage anterograde FURS through the original access. The mean operative time and postoperative hospital stay were 68.2±21.6min and 6.2±1.3 days. Compared with preoperative serum creatinine changes, 2 cases showed slight increase (mean 12.6±0.3μmol/L), 3 cases showed significant decrease (mean 329.6±216.6μmol/L), and the other 9 cases showed no significant change (range<10μmol/L), among which 5 cases showed an increase (mean 5.4±0.7 μmol/L) and 4 cases showed a decrease (mean 3.7±0.4 μmol/L). The mean decrease of hemoglobin was 9.3±4.1g/L. Two patients had fever and their body temperature returned to normal after anti-inflammatory treatment. No blood transfusion, abdominal organ injury or urogenic sepsis occurred.Conclusions:Invasive anterograde multiple endoscopic treatment of upper urinary tract stones in allograft kidney is a single or combined operation using single-channel PCNL, multi-channel PCNL of different sizes and diameters and anterograde FURS according to individual differences, which can effectively reduce renal function injury is safe, efficient and feasible.

16.
Chinese Journal of Ultrasonography ; (12): 252-259, 2022.
Article in Chinese | WPRIM | ID: wpr-932398

ABSTRACT

Objective:To identify the risk factors for survival prognosis of patients with early-stage hepatocellular carcinoma (HCC) after ultrasound-guided percutaneous microwave ablation (US-PMMA), and to compare the overall survival (OS), cancer specific survival (CSS) and disease-free survival (DFS) between different early-stage HCC patients.Methods:A total of 1 563 patients with early-stage hepatocellular carcinoma (HCC) who underwent MWA in the interventional ultrasound department of the Chiese PLA General Hospital from January 2002 to December 2017 were retrospectively analyzed. Propensity score matching (PSM) balanced the baseline parameters between the elderly group (≥60 years) and the young group (<60 years). Multivariate Cox regression analysis was used to identify the risk factors of OS, CSS and DFS. OS, CSS and DFS probabilities for different patients stratified by respective predictors were calculated with Kaplan-Meier method and compared using the Log-Rank test.Results:All parameters were balanced except for age after PSM.Tumor diameter(95% CI=1.1-1.4, P<0.001), number of tumors(95% CI=1.2-1.9, P<0.001), γ-GT (95% CI=1.0-1.0, P<0.001) and AFP (HR=1.5, 95% CI=1.2-1.8, P<0.001) were shared predictors for OS, CSS and DFS. Age (95% CI=1.2-1.8, P<0.001) and neutrophile to lymphocyte ratio (NLR) (95% CI=1.0-1.0, P=0.043) were another two predictors for both OS and CSS. Albumin predicted OS only, and sex and cirrhosis just predicted DFS. Over the follow-up period (12-156 months), log-rank tests showed that all predictors significantly affected the corresponding OS, CSS or DFS(all P<0.01). Among them, multiple tumors had the greatest impact on OS, CSS and DFS. Compared with patients with single lesion, OS, CSS and DFS in patients with multiple lesions decreased by 9.2%, 2.5% and 4.1% respectively at the 12 years of follow-up, and the median survival time was shortened by 12.3 months, 25.0 months and 11.3 months, respectively (log-rank P=0.049 for OS; P=0.007 for CSS; P<0.001 for DFS). Conclusions:The prognostic benefits from MWA treating early-stage HCC in patients with different survival risk factors are different. Clinically feasible correction of hypoproteinemia and liver disfunction are of great significance to improve the prognosis of early-stage HCC patients after US-PMMA.

17.
Chinese Journal of Primary Medicine and Pharmacy ; (12): 423-427, 2022.
Article in Chinese | WPRIM | ID: wpr-931636

ABSTRACT

Objective:To investigate the clinical efficacy of ultrasound-guided percutaneous sclerotherapies for a simple renal cyst.Methods:A total of 120 patients with a simple renal cyst who received treatment in the Department of Urology, Changxing People's Hospital from January 2017 to January 2020 were included in this study. All patients underwent ultrasound-guided percutaneous sclerotherapies followed by medical absolute ethanol perfusion (retention treatment group, n = 40), medical absolute ethanol flushing (flushing replacement group, n = 40), and polidocanol perfusion (polidocanol treatment, n = 40). General data, operation, the incidence of complications, and surgical efficacy were compared between the three groups. Results:There were no significant differences in sex, age, course of the disease, cyst size, and cyst distribution among the three groups (all P > 0.05). The Visual Analog Scale score, length of hospital stay, and medical cost in the polidocanol treatment group were (1.98 ± 0.63) points, (3.54 ± 1.25) days, and (6271.34 ± 831.20) yuan respectively, which were significantly lower than those in the retention treatment group [(3.98 ± 1.26) points, (5.87 ± 1.76) days, (8798.45 ± 981.76) yuan and flushing replacement group [(3.05 ± 1.02) points, (4.35 ± 1.42) days, (7 128.19 ± 921.70) yuan]. There were significant differences in The Visual Analog Scale score, length of hospital stay, and medical cost between groups ( t = 8.97, 6.82, 12.42, all P < 0.001). The incidence of complications in the retention treatment, flushing replacement, and polidocanol treatment groups was 25.00% (10/40), 12.50% (5/40), 5.00% (2/40), respectively ( χ2 = 6.71, P = 0.035). The total response rate in the retention treatment, flushing replacement, and polidocanol treatment groups was 75.00% (30/40), 82.50% (33/40) and 97.50% (39/40), respectively ( χ2 = 8.23, P = 0.016). Conclusion:Ultrasound-guided percutaneous sclerotherapy with polidocanol is effective on a simple renal cyst. The sclerotherapy with polidocanol has a low incidence of complications, shortens the postoperative rehabilitation process, and has a good prognosis.

18.
Chinese Journal of Digestive Endoscopy ; (12): 655-657, 2022.
Article in Chinese | WPRIM | ID: wpr-958305

ABSTRACT

Clinical data of 5 patients with pancreatic and liver lesions who underwent endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) in the Department of Gastroenterology of Beijing Friendship Hospital from February to May 2020 were analyzed retrospectively. Pancreatic lesions were located in the head of pancreas in 3 cases, the neck of pancreas in 1 case and the body of pancreas in 1 case, with the maximum diameter of 3.2-4.6 cm. The histological and cytologic results of pancreas were all positive in 5 patients after 2-4 needles of aspiration. Three patients had single lesion in left lobe of liver, 1 had multiple lesions in left lobe of liver, and 1 had multiple lesions in left and right lobe of liver. The maximum diameter of liver lesions were 0.4-1.2 cm. After 1-3 needles of aspiration, the histological and (or) cytologic results of liver were positive in 4 of 5 patients, only 1 patient's cytologic result was negative. No associated complications were recorded. EUS-FNA for pancreatic and liver lesions is safe and effective.

19.
Chinese Journal of Digestive Endoscopy ; (12): 635-640, 2022.
Article in Chinese | WPRIM | ID: wpr-958301

ABSTRACT

Objective:To evaluate the efficacy and safety of lumen-apposing metal stent (LAMS) for the treatment of pancreatic walled-off necrosis (WON).Methods:A retrospective cohort study was performed on data of 43 consecutive patients with pancreatic WON who underwent endoscopic ultrasound-guided drainage by LAMS or plastic stents (PS) in Hangzhou First People's Hospital from December 2010 to June 2020. According to the type of stent used, the patients were divided into the LAMS group ( n=16) and the PS group ( n=27). The technical success rate, the clinical success rate, the operation time, the session of endoscopic necrosectomy, the stent insertion time and adverse events were compared between the two groups. Results:All 43 patients were successfully stented, indicating a technical success rate of 100% in both groups. For the LAMS group, the clinical success rate, the operation time, the session of endoscopic necrosectomy, the stent insertion time and overall incidence of adverse events were 75.0% (12/16), 26.0 (19.1, 39.8) min, 0.5 (0, 2.0) times, (41.3±28.4) days, and 43.7% (7/16), respectively, whereas these indices of the PS group were 37.0% (10/27) ( χ2=5.795, P=0.016), 31.0 (26.0, 48.0) min ( Z=1.221, P=0.222), 0 (0, 0) times ( Z=2.245, P=0.025), (176.1±99.1) days ( t=5.187, P<0.001) and 14.8% (4/27) ( χ2=8.893, P=0.064), respectively. Conclusion:LAMS placement is safe and effective for the treatment of pancreatic WON with a higher clinical success rate compared with PS. However, it requires more endoscopic intervention.

20.
Chinese Journal of Ultrasonography ; (12): 889-892, 2022.
Article in Chinese | WPRIM | ID: wpr-956668

ABSTRACT

Objective:To investigate the safety and efficacy of ultrasound-guided transversus abdominis plane (TAP) combined with paracervical block in percutaneous microwave ablation(PMWA) of uterine fibroids.Methods:Twenty-four patients with uterine fibroids who underwent PMWA after ultrasound-guided TAP combined with paracervical block in Sichuan Cancer Hospital from October 2021 to January 2022 were retrospectively analyzed. The success rate and adverse reactions of TAP combined with paracervical block were recorded, and the types and doses of rescue analgesics used during and after operation were recorded. The pain degree of patients was recorded by NRS(numeric rating scales) during and 30 minutes, 1 hour, 2 hours, 4 hours, 6 hours, 12 hours and 24 hours after operation, and the satisfaction of patients was recorded.Results:The success rate of TAP combined with paracervical block was 100%, and there were no adverse reactions during and after operation. During the operation, 5 patients(20.83%) had mild pain, which was tolerable and did not need intervention, 4 patients(16.67%) presented with moderate pain, and the NRS scores were 4, 4, 5 and 6 respectively, the symptoms were relieved after rescue analgesia. All patients completed one ablation, no ablation failure or secondary ablation. Some patients had mild pain after operation, which could be tolerated without intervention, and all were relieved naturally within 6 hours. All patients returned home on the day of ablation and were 100% satisfied with the analgesic effect.Conclusions:Ultrasound-guided TAP combined with paracervical block in PMWA of uterine fibroids is safe and effective, which is worthy of clinical promotion.

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