Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 2.211
Filtrar
1.
Int Heart J ; 62(2): 367-370, 2021 Mar 30.
Artigo em Inglês | MEDLINE | ID: mdl-33731523

RESUMO

This study aimed to improve and further explore a ventricular septal defect (VSD) canine model on the basis of the transcatheter puncture method and to evaluate its application and teaching value.In order to lessen the complications of VSD closure, it is necessary to improve the currently available treatment devices using appropriate animal models.In this study, we used 16 healthy adult canines as our models. After anesthesia, the VSD puncture was performed, followed by balloon dilatation of the perforation. VSD was confirmed by angiography. The venous-artery orbit was established, and the VSD was then closed once the catheter and occluder were across the defect.Of the experimental canines, 14 of the 16 canines were successfully modeled, giving a success rate of 87.5%. The canines underwent an immediate creation of a venous-artery orbit for teaching practice and were implanted with an occluder during the procedure. After 4 weeks, 13 canines survived. As per our findings, most VSD types established by the puncture were perimembranous (10 of 13, 77%).The current model has a high success rate. The model can not only avoid the risk of infection and hemodynamic disorders associated with an open thoracotomy, but can also be effectively used in evaluating the impact of occluders. It can also directly measure the parameters of the devices during the procedure, thus having a very high experimental and teaching value.


Assuntos
Cateterismo Cardíaco/métodos , Procedimentos Cirúrgicos Cardíacos/educação , Educação de Pós-Graduação em Medicina/métodos , Comunicação Interventricular/cirurgia , Punções/métodos , Ensino , Animais , Procedimentos Cirúrgicos Cardíacos/métodos , Modelos Animais de Doenças , Cães , Feminino , Fluoroscopia , Comunicação Interventricular/diagnóstico , Masculino
2.
Arch. Soc. Esp. Oftalmol ; 96(2): 97-101, feb. 2021. ilus
Artigo em Espanhol | IBECS | ID: ibc-200795

RESUMO

Para evitar el desgarro radial de la cápsula anterior al realizar la capsulorrexis circular continua (CCC) que puede ocurrir durante la cirugía en las cataratas blancas intumescentes, el conocido como signo de la bandera argentina cuando se asocia la CCC a una tinción capsular previa con azul de tripano, se hace una punción inicial de la cápsula anterior con una aguja 30 G, como primer paso del procedimiento quirúrgico, es decir, previo a cualquier apertura de la cámara anterior. Este acto parece permitir que la presión del compartimento intracristaliniano y la presión de la cámara anterior se igualen, al liberarse el contenido licuado de la catarata blanca intumescente en una cámara anterior presumiblemente hermética, evitando el temido desgarro radial capsular anterior. Esta técnica, denominada blancopunción, ha sido utilizada en 174 casos sin ninguna complicación asociada


In order to avoid radial tearing of the anterior capsule while performing continuous circular capsulorhexis (CCC) in a white intumescent cataract, called the "Argentinian flag sign" when CCC is associated with a previous capsular stain with trypan blue, an initial puncture of the anterior capsule is performed with a 30G needle as the first step of the surgical procedure, that means, prior to any previous aperture of the anterior chamber. This act seems to allow the pressure of the intracrystalline space and the pressure of the anterior chamber to be equalized, as the liquefied content of the intumescent white cataract is released into a presumably hermetic anterior chamber, avoiding the dreaded anterior capsular radial tear. This technique, called "white-puncture", has been used in 174 cases without any associated complications


Assuntos
Humanos , Complicações Intraoperatórias/prevenção & controle , Ruptura da Cápsula Anterior do Olho/prevenção & controle , Capsulorrexe/métodos , Punções/métodos , Capsulorrexe/efeitos adversos , Ilustração Médica , Resultado do Tratamento
3.
Int J Comput Assist Radiol Surg ; 16(3): 475-484, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33484429

RESUMO

PURPOSE: Ultrasound (US)-guided percutaneous puncture technology can realize real-time, minimally invasive interventional therapy without radiation. The location accuracy of the puncture needle directly determines the precision and safety of the operation. It is a challenge for novices and young surgeons to perform a free-hand puncture guided by the ultrasound images to achieve the desired accuracy. This work aims to develop a robotic system to assist surgeons to perform percutaneous punctures with high precision. METHODS: An US-guided puncture robot was designed to allow the mounting and control of the needle to achieve localization and insertion. The US probe fitted within the puncture robot was held by a passive arm. Moreover, the puncture robot was calibrated with a novel calibration method to achieve coordinate transformation between the robot and the US image. The system allowed the operators to plan the puncture target and puncture path on US images, and the robot performed needle insertion automatically. Five groups of puncture experiments were performed to verify the validity and accuracy of the proposed robotic system. RESULTS: Assisted by the robotic system, the positioning and orientation accuracies of the needle insertion were 0.9 ± 0.29 mm and 0.76 ± 0.34°, respectively. These are improved compared with the results obtained with the free-hand puncture (1.82 ± 0.51 mm and 2.79 ± 1.32°, respectively). Moreover, the proposed robotic system can reduce the operation time and number of needle insertions (14.28 ± 3.21 s and one needle insertion, respectively), compared with the free-hand puncture (25.14 ± 6.09 s and 1.96 ± 0.68 needle insertions, respectively). CONCLUSION: A robotic system for percutaneous puncture guided by US images was developed and demonstrated. The experimental results indicate that the proposed system is accurate and feasible. It can assist novices and young surgeons to perform the puncture operation with increased accuracy.


Assuntos
Agulhas , Imagens de Fantasmas , Punções/métodos , Procedimentos Cirúrgicos Robóticos/métodos , Cirurgia Assistida por Computador/métodos , Ultrassonografia de Intervenção/instrumentação , Ultrassonografia de Intervenção/métodos , Calibragem , Desenho de Equipamento , Humanos , Movimento , Reprodutibilidade dos Testes , Robótica , Ultrassonografia
4.
Pediatr Cardiol ; 42(3): 685-691, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33454819

RESUMO

Transseptal puncture (TSP) is a standard procedure to obtain access to the left heart. However, data on TSP in infants and children particularly with congenital heart defects (CHD) is sparse. Safety and efficacy of TSP in infants and children < 18 years with normal cardiac anatomy and with CHD were assessed. 327 TSP were performed in a total of 300 individuals < 18 years from 10/2002 to 09/2018 in our tertiary pediatric referral center. Median age at TSP was 11.9 years (IQR 7.8-15; range: first day of life to 17.9 years). 13 subjects were < 1 year. Median body weight was 43.8 kg (IQR 26.9-60; range: 1.8-121 kg). CHD was present in 28/327 (8.6%) procedures. TSP could be successfully performed in 323/327 (98.8%) procedures and was abandoned in 4 procedures due to imminent or incurred complications. Major complications occurred in 4 patients. 3 of these 4 subjects were ≤ 1 year of age and required TSP for enlargement of a restrictive atrial septal defect in complex CHD. Two of these babies deceased within 48 h after TSP attempt. The third baby needed urgent surgery in the cath lab. Pericardial effusion requiring drainage was noted in the forth patient (> 1 year) who was discharged well later. Minor complications emerged in 5 patients. The youngest of these individuals (0.3 years, 5.8 kg) developed small pericardial effusion after anterograde ballon valvuloplasty for critical aortic stenosis. The remaining 4/5 patients developed small pericardial effusion after ablation of a left-sided accessory atrioventricular pathway (6.1-12.2 years, 15.6-34.0 kg). TSP for access to the left heart was safe and effective in children and adolescents > 1 year of age. However, TSP was a high-risk procedure in small infants with a restrictive interatrial septum with need for enlargement of interatrial communication.


Assuntos
Septo Interatrial/cirurgia , Procedimentos Cirúrgicos Cardíacos/métodos , Cardiopatias Congênitas/cirurgia , Punções/métodos , Adolescente , Procedimentos Cirúrgicos Cardíacos/efeitos adversos , Estudos de Casos e Controles , Criança , Pré-Escolar , Feminino , Átrios do Coração/cirurgia , Humanos , Lactente , Recém-Nascido , Masculino , Punções/efeitos adversos , Estudos Retrospectivos
5.
BMJ Case Rep ; 14(1)2021 Jan 26.
Artigo em Inglês | MEDLINE | ID: mdl-33500306

RESUMO

An 83-year-old man experienced left upper limb uncontrolled movements preceded by intense gasping during night rest, which progressed to unconsciousness and respiratory arrest requiring intubation. He was diagnosed with acute stroke due to distal occlusion of the basilar artery and received indication for endovascular thrombectomy. Standard endovascular approach includes percutaneous puncture of the femoral or radial arteries; however, the presence of unfavourable vascular anatomies (stenotic origin and tortuosity) did not allow catheterisation of the intracranial vessels through conventional access, and based on the consistent time lapse from onset of symptoms and deterioration of the clinical condition, a direct right vertebral artery ultrasound-guided puncture was performed. After one attempt of a triaxial technique, a complete recanalisation of the basilar artery and of its distal branches was achieved. Direct percutaneous puncture of the vertebral artery represents a rescue access strategy for treatment of posterior circulation stroke when other routes are not feasible.


Assuntos
Procedimentos Endovasculares/métodos , Punções/métodos , Trombectomia/métodos , Artéria Vertebral/cirurgia , Insuficiência Vertebrobasilar/cirurgia , Idoso de 80 Anos ou mais , Angiografia Cerebral , Angiografia por Tomografia Computadorizada , Artéria Femoral , Humanos , Masculino , Cirurgia Assistida por Computador , Ultrassonografia , Dispositivos de Oclusão Vascular , Artéria Vertebral/diagnóstico por imagem , Insuficiência Vertebrobasilar/diagnóstico por imagem , Insuficiência Vertebrobasilar/fisiopatologia
6.
J Clin Neurosci ; 82(Pt A): 71-75, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33317742

RESUMO

PURPOSE: To introduce a tooth-supported personalized template-assisted foramen ovale (FO) puncture system for trigeminal neuralgia (TN) treatment, analyze its advantages, and review other previously reported methods. METHODS: Sixty-seven patients were included. According to the preoperative digital design, the personalized puncture path was determined. Then, a tooth-supported personalized template was designed and manufactured. Finally, surgery (radiofrequency thermocoagulation or balloon compression) was carried out with the assistance of the template. The puncture effect and puncture-associated complications were evaluated, and the related literature was reviewed. RESULTS: The FO was successfully punctured in one attempt in all patients. The procedure was completed in 15 s in 35 (52.24%) patients and in 15-30 s in 28 (41.79%) patients. The required position was accurately reached in all patients, and the center point error range was within 1 mm. No complications associated with puncture occurred. CONCLUSION: The tooth-supported personalized template-assisted FO puncture system reported in this paper is an exceedingly simple, highly effective and safe FO puncture method that is worth popularizing.


Assuntos
Desenho de Equipamento , Forame Oval/cirurgia , Medicina de Precisão/métodos , Punções/métodos , Cirurgia Assistida por Computador/métodos , Neuralgia do Trigêmeo/cirurgia , Idoso , Oclusão com Balão/métodos , Eletrocoagulação/métodos , Feminino , Humanos , Pessoa de Meia-Idade , Impressão Tridimensional
7.
Medicine (Baltimore) ; 99(44): e22468, 2020 Oct 30.
Artigo em Inglês | MEDLINE | ID: mdl-33126302

RESUMO

RATIONAL: Vertebral compression fracture (VCF) is one of the most common diseases in spinal surgery. Traditional percutaneous vertebroplasty (PVP) under fluoroscopy is an effective method to treat vertebral compression fracture. However, there is still a risk of vascular nerve injury and infection caused by inaccurate or repeated puncture. Therefore, the purpose of this paper was to assess the accuracy of unilateral PVP guided by screw view model of navigation (SVMN) for VCF. PATIENT CONCERNS: A 59-year-old female patient suffered high falling injury, and with back pain as its main clinical symptom. DIAGNOSES: The patient was diagnosed with a L1 VCF. INTERVENTIONS: We placed the puncture needle under the guidance of SVMN to reach the ideal position designed before operation, and then injected the bone cement to complete the percutaneous kyphoplasty (PKP). OUTCOMES: The operative time was 29.5 minutes, the puncture time was 1 time, the fluoroscopy time was 2.9 minutes, and the bone cement distribution was satisfactory. VAS and ODI scores were significant improved postoperatively. No surgical complications, including neurovascular injury and infection, were observed during 28-month follow up. LESSONS: The SVMN guided percutaneous puncture needle insertion in PKP operation for VCF is an effective and safety technique. Besides, the SVMN has also been a contributor to reduce radiation doses and replace conventional fluoroscopy.


Assuntos
Fraturas por Compressão/cirurgia , Vértebras Lombares/lesões , Neuronavegação/métodos , Fraturas da Coluna Vertebral/cirurgia , Vertebroplastia/métodos , Cimentos Ósseos , Feminino , Humanos , Cifoplastia/métodos , Pessoa de Meia-Idade , Punções/métodos , Resultado do Tratamento
9.
PLoS One ; 15(7): e0236295, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32706813

RESUMO

The purpose of the present study was to integrate an interactive gradient-based needle navigation system and to evaluate the feasibility and accuracy of the system for real-time MR guided needle puncture in a multi-ring phantom and in vivo in a porcine model. The gradient-based navigation system was implemented in a 1.5T MRI. An interactive multi-slice real-time sequence was modified to provide the excitation gradients used by two sets of three orthogonal pick-up coils integrated into a needle holder. Position and orientation of the needle holder were determined and the trajectory was superimposed on pre-acquired MR images. A gel phantom with embedded ring targets was used to evaluate accuracy using 3D distance from needle tip to target. Six punctures were performed in animals to evaluate feasibility, time, overall error (target to needle tip) and system error (needle tip to the guidance needle trajectory) in vivo. In the phantom experiments, the overall error was 6.2±2.9 mm (mean±SD) and 4.4±1.3 mm, respectively. In the porcine model, the setup time ranged from 176 to 204 seconds, the average needle insertion time was 96.3±40.5 seconds (min: 42 seconds; max: 154 seconds). The overall error and the system error was 8.8±7.8 mm (min: 0.8 mm; max: 20.0 mm) and 3.3±1.4 mm (min: 1.8 mm; max: 5.2 mm), respectively.


Assuntos
Biópsia por Agulha , Biópsia Guiada por Imagem , Imageamento por Ressonância Magnética , Punções , Animais , Biópsia por Agulha/instrumentação , Biópsia por Agulha/métodos , Biópsia Guiada por Imagem/instrumentação , Biópsia Guiada por Imagem/métodos , Imageamento por Ressonância Magnética/instrumentação , Imageamento por Ressonância Magnética/métodos , Agulhas , Imagens de Fantasmas , Punções/instrumentação , Punções/métodos , Suínos
10.
Rev Col Bras Cir ; 47: e20202558, 2020 Jun 03.
Artigo em Português, Inglês | MEDLINE | ID: mdl-32578821

RESUMO

The coronavirus infection, also known as SARS-COV2, has proven to be potentially fatal, representing a major global health problem. Its spread after its origin in the city of Wuhan, China has resulted in a pandemic with the collapse of the health system in several countries, some with enormous social impact and expressive number of deaths as seen in Italy and Spain. Extreme intra and extra-hospital measures have been implemented to decrease the transmission and dissemination of the COVID-19. Regarding the surgical practice, a huge number of procedures considered non-essential or elective were cancelled and postponed until the pandemic is resolved. However, urgent and oncological procedures have been carried out. In this publication, we highlight and teach adaptations to be made with commonly used materials in laparoscopy to help prevent the spread and contamination of the healthcare team assisting surgical patients.


Assuntos
Aerossóis/efeitos adversos , Infecções por Coronavirus/prevenção & controle , Laparoscopia/métodos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Procedimentos Cirúrgicos Robóticos/métodos , Procedimentos Cirúrgicos Operatórios/normas , Betacoronavirus , Transmissão de Doença Infecciosa/prevenção & controle , Humanos , Período Intraoperatório , Salas Cirúrgicas/métodos , Pneumoperitônio Artificial/normas , Equipamentos de Proteção/normas , Punções/métodos , Instrumentos Cirúrgicos/normas
12.
Turk Neurosurg ; 30(4): 565-572, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32530475

RESUMO

AIM: To compare neuroendoscopy versus minimal puncture drainage for surgical treatment of supratentorial hypertensive intracerebral hemorrhage. MATERIAL AND METHODS: A total of 108 cases involving supratentorial intracerebral hemorrhage were retrospectively analyzed. In 30 cases, endoscopic surgery was performed, while 78 cases involved puncture surgery. We compared hematoma clearance rate, postoperative rebleeding rate, incidence of postoperative complications, operation duration, and Glasgow coma score seven days after surgery. Clinical data such as early postoperative rehabilitation time, Glasgow outcome score three months after surgery, and intensive care unit (ICU) stay were also compared between the two groups. RESULTS: The results showed that endoscopic surgery was associated with a superior clinical therapeutic effect in hematoma clearance rates, GCS scores on postoperative day 7, the average ICU stay, early postoperative rehabilitation time and intracranial infection outcomes than minimal puncture drainage surgery for the treatment of supratentorial intracerebral hemorrhage (p < 0.05). Three months after surgery, the favorable prognosis rate in the endoscopic treatment group was significantly higher than that in the craniotomy group [83.3% (28/34) vs. 61.5% (31/51), respectively; ? < sup > 2 < /sup > =4.698, p=0.030]. In contrast, no significant differences in rebleeding, pulmonary infection, tracheotomy, secondary epilepsy, gastrointestinal hemorrhage, death in late postoperative period, or in baseline parameters were observed between the two groups (p > 0.05). CONCLUSION: Endoscopic surgery potentially represents a beneficial surgical procedure for treatment of supratentorial spontaneous intracerebral hemorrhage.


Assuntos
Drenagem/métodos , Hemorragia Intracraniana Hipertensiva/diagnóstico por imagem , Hemorragia Intracraniana Hipertensiva/cirurgia , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Neuroendoscopia/métodos , Punções/métodos , Adulto , Idoso , Craniotomia/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Resultado do Tratamento
14.
Urologe A ; 59(9): 1017-1025, 2020 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-32533201

RESUMO

BACKGROUND: Percutaneous access to the renal pelvis still remains the most difficult step before nephrolitholapaxy (PCNL). New imaging techniques, such as 3D imaging and various navigation instruments such as electromagnetic, sonographic, CT-controlled and marker-based/iPAD try to simplify this step and reduce complications. OBJECTIVES: In this review, various new techniques for puncturing the renal collecting system are presented and their advantages and disadvantages are evaluated. MATERIALS AND METHODS: A systematic literature search was carried out in MEDLINE, whereby only puncture techniques that have already been evaluated in clinical studies were included. RESULTS: Five different navigation methods for puncturing the renal pelvis before PCNL were found. CONCLUSION: Intraoperative navigation can be useful when puncturing the collecting system. The combination of ultrasound and fluoroscopy currently remains the gold standard. However, there is still a need for further, primarily clinical, prospective studies to determine which new imaging technology and navigation systems will prevail and thus facilitate the access route to the kidney, especially in the case of special anatomical conditions.


Assuntos
Cálculos Renais/cirurgia , Rim/diagnóstico por imagem , Rim/cirurgia , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Nefrostomia Percutânea/métodos , Punções/métodos , Humanos , Cálculos Renais/diagnóstico por imagem
15.
Anticancer Res ; 40(6): 3527-3534, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32487654

RESUMO

BACKGROUND/AIM: To compare the diagnostic reliability, accuracy and safety of ultrasound-guided biopsy (Tru-Cut biopsy) and ascites puncture in patients with a primarily inoperable malignant ovarian tumor. PATIENTS AND METHODS: This is a retrospective analysis of the studied methods in consecutively examined patients and a prospective validation of these methods. 79 women with a suspected primarily inoperable ovarian tumor underwent Tru-Cut biopsies and were included in the ultrasound-guided biopsy group. In addition, 55 patients after ascites puncture were enrolled in the comparison group. Both procedures were performed in 48 patients for the prospective validation. RESULTS: Significant differences in favour of ultrasound-guided biopsy were found in all studied variables (malignancy confirmation 72.9% vs. 95.8%, tumor origin 52.1% vs. 89.6%, histologic subtype 43.8% vs. 85.4% and accuracy, i.e. agreement of preoperative and definitive diagnosis 43.7% vs. 95.4%). CONCLUSION: Ultrasound-guided biopsy is an accurate, reliable, safe and minimally invasive method. Owing to the high reliability and accuracy, it has the capacity to replace ascites puncture with cytologic examination or a more invasive method (laparoscopy, laparotomy) for adequate tumor sampling.


Assuntos
Biópsia Guiada por Imagem , Neoplasias Ovarianas/diagnóstico , Punções , Ultrassonografia , Ascite/patologia , Citodiagnóstico , Feminino , Histocitoquímica , Humanos , Biópsia Guiada por Imagem/métodos , Biópsia Guiada por Imagem/normas , Punções/métodos , Reprodutibilidade dos Testes , Estudos Retrospectivos , Ultrassonografia/métodos
16.
J Cancer Res Ther ; 16(2): 258-262, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32474510

RESUMO

Aims: The goal of this study was to analyze the puncture routes of imaging-guided thermal ablation for tumors of the hepatic caudate lobe. Materials and Methods: The imaging-guided thermal ablation puncture routes of 12 cases of hepatic caudate lobe tumors were collected in our hospital from January 2013 to February 2019. The puncture routes were retrospectively analyzed, and the experience of thermal ablation therapy for hepatic caudate lobe tumors was summarized. Results: Among the 12 cases of hepatic caudate lobe tumors, puncture routes were divided into the anterior (through the left lobe of the liver) approach (six cases), the right hepatic approach (five cases), and the transthoracic approach (one case). Different ablation electrodes were selected according to the puncture route and method of guiding. No serious postoperative complications were noted. Conclusion: The hepatic caudate lobe is surrounded by the inferior vena cava, hepatic vein, and hepatic hilum, leading to great difficulties and risks in performing minimally invasive treatment of hepatic caudate lobe malignancies. Therefore, selecting an appropriate puncture route is an important factor in the success of the treatment.


Assuntos
Carcinoma Hepatocelular/cirurgia , Hipertermia Induzida/métodos , Neoplasias Hepáticas/cirurgia , Imageamento por Ressonância Magnética/métodos , Punções/métodos , Cirurgia Assistida por Computador/métodos , Tomografia Computadorizada por Raios X/métodos , Adulto , Idoso , Carcinoma Hepatocelular/diagnóstico por imagem , Carcinoma Hepatocelular/patologia , Feminino , Humanos , Neoplasias Hepáticas/diagnóstico por imagem , Neoplasias Hepáticas/patologia , Masculino , Pessoa de Meia-Idade , Ablação por Radiofrequência/métodos , Estudos Retrospectivos , Resultado do Tratamento , Veia Cava Inferior
17.
Medicine (Baltimore) ; 99(15): e19656, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32282716

RESUMO

To determine the influence of puncture site on aspiration in dealing with pneumothorax following CT-guided lung biopsy.Two hundred thirty-six pneumothorax patients after CT guided lung biopsies were retrospective analyzed from January 2013 to December 2018. Patients with minor asymptomatic pneumothorax were treated conservatively with monitoring of vital signs and follow-up CT to confirm stability. Ninety of the 236 pneumothorax patients, who underwent manual aspiration, were included in this analysis. In first manual aspiration, the needle from the lesion was retracted back into the pleural space after biopsy, and then aspiration treatment was performed. If the treatment is of unsatisfied result, a second attempt aspiration treatment, which puncture site away from initial biopsy one, was conducted. The efficacy of simple manual aspiration and the new method, changing puncture site for re-aspiration was observed.Immediate success was obtained in 62 out of the 90 patients in the first attempt. The effective rate and failure rate were 68.9% (62/90) and 31.1% (28/90), respectively. Twenty-eight patients in whom first attempt simple aspiration were unsuccessful underwent a second attempt aspiration, which puncture site away from initial biopsy one, was successful in 13 patients with 15 patients undergoing chest tube placement. The effective rate and failure rate were 46.4% (13/28) and 53.6% (15/28), respectively. Applying the modified procedure, total effective rate of aspiration elevated significantly from 68.9% (62/90) to 83.3% (75/90) (P < .05). No serious side effects were detected in the period of aspiration procedure.Manual aspiration with puncture site away from initial biopsy one is worth trying to deal with post-biopsy pneumothorax. This modified procedure improved the efficiency of treatment significantly, and reduced the rate of pneumothorax requiring chest tube placement.


Assuntos
Biópsia Guiada por Imagem/efeitos adversos , Pulmão/patologia , Pneumotórax/etiologia , Punções/efeitos adversos , Idoso , Tubos Torácicos/estatística & dados numéricos , Feminino , Humanos , Biópsia Guiada por Imagem/instrumentação , Pulmão/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Cavidade Pleural/patologia , Pneumotórax/terapia , Punções/métodos , Estudos Retrospectivos , Sucção/efeitos adversos , Sucção/métodos , Tomografia Computadorizada por Raios X/métodos , Falha de Tratamento
19.
Pesqui. vet. bras ; 40(3): 158-164, Mar. 2020. tab
Artigo em Inglês | LILACS, VETINDEX | ID: biblio-1135602

RESUMO

This study aimed to evaluate the appropriate sites of abdominocentesis for peritoneal fluid collection in cattle and to investigate the time of cell viability in vitro, comparing three methods of sample conservation. Twenty-one healthy cattle (19 females and 2 males) were subjected to a laparocentesis procedure to obtain peritoneal fluid, with punctures in three defined sites: left cranial, right cranial, and right caudal. The total peritoneal fluid collected was divided into three aliquots and maintained under three preservation conditions: room temperature (26°C), refrigeration (4°C), and room temperature (26°C) with the addition of 1µL of 10% formaldehyde per 1mL of peritoneal fluid. The peritoneal fluid analysis performed immediately after collection consisted of: physical examination (color, appearance, volume, and specific gravity), biochemical measures (pH, total protein, fibrinogen, creatinine, and glucose), and cellularity (total and differential counts). The determination of proteins and the examination of cells were repeated in each separate aliquot at two, four, six, and eight hours after harvest. Data were analyzed through repeated measures ANOVA or Friedman test. The harvest was productive in 67% of cattle. The left cranial and the right cranial puncture sites were the most appropriate. Peritoneal fluid analyzed after collection, the total protein concentration ranged from 1.4 to 3.6g/dL, and number of leukocytes ranged from 54 to 1,322 cells/µL; 60 to 95% of leukocytes were lymphocytes. The protein concentration decreased, but the absolute values of leukocytes, lymphocytes, and segmented neutrophils did not change up to eight hours after collection, independent of the maintenance method. Cell lysis was delayed by cooling, and the addition of formaldehyde did not help preserve the integrity of cellular morphology. Laparocentesis is a safe and secure procedure in cattle and maybe more productive when performed in specific sites on the left or right sides of the cranial abdominal wall. Peritoneal fluid samples may be analyzed with reliable results for up to eight hours after collection when kept refrigerated and for up to six hours when kept at room temperature.(AU)


O estudo teve como objetivo avaliar os locais adequados de laparocentese para a colheita de fluido peritoneal de bovinos e estabelecer o tempo de viabilidade celular in vitro, comparando três métodos de conservação. Vinte e um bovinos hígidos (19 fêmeas e 2 machos) foram submetidos ao procedimento de laparocentese para obtenção de fluido peritoneal, com punção em três pontos definidos: cranial esquerdo, cranial direito e caudal direito. O volume total do líquido peritoneal foi dividido em três alíquotas mantidas sob três métodos de conservação: temperatura ambiente (26°C); refrigeração (4°C); e temperatura ambiente (26°C) com adição de 1µL de formol 10% para cada 1mL de líquido peritonial. A análise do líquido peritoneal realizada imediatamente após sua obtenção consistiu em: exames físico (cor, aspecto, volume e densidade); bioquímicos (pH, proteína total, fibrinogênio, creatinina e glicose); e da celularidade (contagens total e diferencial). A determinação de proteínas e o exame da celularidade foram repetidos, em cada alíquota separada, as duas, quatro, seis e oito horas após a colheita. Análise de variâncias de medidas repetidas ou teste de Friedman foram empregados para avaliação ao longo do tempo. A colheita foi produtiva em 67% dos bovinos e os locais de punção craniais esquerdo e direito foram os mais adequados. A concentração de proteína total variou de 1,4 a 3,6g/dL e o número de leucócitos de 54 a 1.322 células/µL, com predomínio de linfócitos (60 a 95% das células) no fluido peritoneal analisado logo após a colheita. A concentração de proteínas diminuiu, mas os valores absolutos de leucócitos, de linfócitos e de neutrófilos segmentados não se modificaram até oito horas após a colheita, independente do método de manutenção das amostras. A lise celular foi retardada pela refrigeração e a adição de formol não contribuiu para preservar a integridade da morfologia celular. A laparocentese é um procedimento seguro e de execução fácil em bovinos sendo mais produtiva quando realizada em locais específicos à esquerda ou à direita craniais da parede abdominal. Amostras de fluido peritoneal podem ser analisadas com resultados confiáveis quando mantidas refrigeradas por até oito horas após a colheita e quando mantidas à temperatura ambiente por até seis horas.(AU)


Assuntos
Animais , Bovinos , Líquido Ascítico/citologia , Líquido Ascítico/química , Punções/métodos , Cavidade Abdominal/patologia , Peritonite/diagnóstico
20.
Ann Thorac Surg ; 109(6): e457-e459, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32035048

RESUMO

A redo surgical approach to residual ventricular septal defect (VSD) is technically demanding. Sternum reentry has to be performed very carefully to avoid any uncontrolled bleeding, and preparation of the adhesions must be made to expose the most important structures (ascending aorta, caval veins). However, percutaneous transcatheter device closure of the residual VSD with radiation exposure can cause arrhythmia, valve injury, and vascular complications. This report presents a less invasive technique to treat residual VSD, without arterial access, radiation exposure, or cardiopulmonary bypass.


Assuntos
Cateterismo Cardíaco/métodos , Procedimentos Cirúrgicos Cardíacos/métodos , Comunicação Interventricular/cirurgia , Punções/métodos , Dispositivo para Oclusão Septal , Criança , Feminino , Comunicação Interventricular/diagnóstico , Humanos , Masculino , Reoperação
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...