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Li Y, Xie Q, Li C, Yang Q, Zhang Z, Yang C, Xu G. Long-term investigation of minimally invasive alcohol-based therapy as the treatment of odontogenic keratocyst:A retrospective cohort study. J Craniomaxillofac Surg 2024; 52:324-333. [PMID: 38368215 DOI: 10.1016/j.jcms.2024.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 12/05/2023] [Accepted: 01/16/2024] [Indexed: 02/19/2024] Open
Abstract
The aim of this study was to evaluate the clinical efficacy of alcohol-based therapy for patients with large odontogenic keratocysts (OKCs). The study was implemented as a retrospective, single-center study. Patients treated with ethanol-based therapy for odontogenic keratocyst were retrospectively evaluated for baseline and postoperative data. The pre- and postoperative clinical situation and the extent of radiographic shrinkage were compared. The event is defined as the achievement of >50% reduction in cyst volume. The cyst reduction rate calculated on panoramic radiographs ranged from 7.4% to 99.9% (mean [standard deviation] 55.3% [27.9%]) and was statistically significant (P < 0.05). Specifically, it has been found that, radiographically, 47.6% of patients achieved >50% reduction in cyst volume within 12 months. The continuous cortical bone was rebuilt, and the cyst cavity was filled with regenerated trabecular bone. The 22 included patients presented with nonclinical problems, had no need for further intervention, and exhibited persistent impaction of the teeth. The results of this study demonstrated that ethanol-based therapy triggered marked radiographic reductions of large OKC, indicating that using this technique is efficient.
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Affiliation(s)
- Yan Li
- Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Department of Oral Surgery, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, PR China
| | - Qianyang Xie
- Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Department of Oral Surgery, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, PR China
| | - Chenlin Li
- Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Department of Oral Surgery, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, PR China; Shanghai Xuhui District Dental Center, Oral and Maxillofacial Surgery, 200011, PR China
| | - Qingran Yang
- Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Department of Oral Surgery, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, PR China
| | - Zhiyuan Zhang
- Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Department of Oral Surgery, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, PR China.
| | - Chi Yang
- Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Department of Oral Surgery, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, PR China.
| | - Guangzhou Xu
- Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Department of Oral Surgery, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, PR China.
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Yoon S, Kwak J, Im D, Yoon H. Review of outcomes of using lower ethanol concentration (83%) in percutaneous ultrasound-guided renal cyst sclerotherapy in dogs. J Vet Sci 2023; 24:e61. [PMID: 37638709 PMCID: PMC10556289 DOI: 10.4142/jvs.23045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 05/26/2023] [Accepted: 06/26/2023] [Indexed: 08/29/2023] Open
Abstract
BACKGROUND Percutaneous renal cyst sclerotherapy (PRCS) as a treatment for renal cysts is usually performed with a high concentration of ethanol (≥ 90%). This study reviewed cases in which a lower concentration of ethanol (83%) was used for the procedure in dogs. METHODS Records of cases of renal cysts treated by sclerotherapy using 83% ethanol in dogs were reviewed. Outcomes of the treatment were evaluated by comparing volumes of renal cysts before the procedure and the volumes after treatment, using ultrasound images with the volume reduction rates classified as follows: < 50% of initial volume (failed); ≥ 50% but < 80% of initial volume (partial success); ≥ 80% but < 95% of initial volume (great success); ≥ 95% of initial volume (complete success). RESULTS Out of nine dog kidneys, renal cysts sclerotherapy with 83% ethanol achieved partial success in one kidney, great success in four, and complete success in the other four. No side effect was observed. The mean of the volume-reduction rates was 90.00 ± 11.00 while the minimum and maximum reduction rates were 65% and 100%, respectively. CONCLUSIONS The lower ethanol concentration (83%) is good for disinfecting kidneys in PRCS.
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Affiliation(s)
- Sanghyeon Yoon
- Department of Veterinary Medical Imaging, College of Veterinary Medicine, Jeonbuk National University, Iksan 54596, Korea
| | - Jungmin Kwak
- Department of Veterinary Medical Imaging, College of Veterinary Medicine, Konkuk University, Seoul 05029, Korea
| | - Deokho Im
- Nel Animal Medical Center, Anyang 14065, Korea
| | - Hakyoung Yoon
- Department of Veterinary Medical Imaging, College of Veterinary Medicine, Jeonbuk National University, Iksan 54596, Korea.
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Kim JH, Jeon UB, Jang JY, Kim TU, Ryu H, Yeom JA, Roh J. Efficacy of single-session 99.5% ethanol sclerotherapy for incidentally found simple renal cysts. Medicine (Baltimore) 2022; 101:e32114. [PMID: 36550842 PMCID: PMC9771283 DOI: 10.1097/md.0000000000032114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Simple renal cysts are the most common masses in the kidney. Most are asymptomatic and are incidentally detected on imaging examinations performed for other reasons. This study aimed to compare the results of 40 and 120 minutes ethanol sclerotherapies that were performed in a single session to treat incidentally found simple renal cysts. We retrospectively reviewed 63 renal cysts in 62 patients treated by single session percutaneous ethanol sclerotherapy. Thirty-one patients with 32 cysts underwent a 40 minutes sclerotherapy (group A), and 31 patients with 31 cysts underwent a 120 minutes retention technique (group B). Under ultrasonographic and fluoroscopic guidance, cystic fluid was completely aspirated, and 50% of the aspirated volume was replaced with 99.5% ethanol (a maximum of 100 mL). Imaging follow-up of the patients was performed 3 months after sclerotherapy. The technical success rates were 100% in both groups. Eighteen patients (29.0%) were symptomatic (flank pain or discomfort). Indications of the other patients were large cysts (>5 cm; 46%) and an increment in the diameter on serial studies (25.4%). A significant difference between the 2 groups in terms of age, cyst diameter, volume of aspirated fluid, volume of injected ethanol, and percentage of reduction in cyst diameter (P > .05) was not found. After treatment, flank pain or discomfort resolved in 17 of 18 (94.4%) symptomatic patients. One patient complained of persistent flank pain; however, no significant abnormality was detected on post-procedural computed tomography images. There were no other complications after therapy in the 2 groups. Single session ethanol sclerotherapy with a 40 minutes retention technique is an effective, safe, and cost-effective method for the treatment of incidentally found simple renal cysts. Although the procedural time was reduced, there was no significant difference in therapeutic efficacy between the 40 and 120 minutes therapies.
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Affiliation(s)
- Jin Hyeok Kim
- Department of Radiology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Ung Bae Jeon
- Department of Radiology, Pusan National University Yangsan Hospital, Yangsan, Korea
- Department of Radiology, School of Medicine, Pusan National University, Yangsan, Korea
- * Correspondence: Ung Bae Jeon, Department of Radiology, Pusan National University Yangsan Hospital, 20 Geumo-ro, Mulgeum-eup, Yangsan, Gyeongnam 50612, Korea (e-mail: )
| | - Joo Yeon Jang
- Department of Radiology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Tae Un Kim
- Department of Radiology, Pusan National University Yangsan Hospital, Yangsan, Korea
- Department of Radiology, School of Medicine, Pusan National University, Yangsan, Korea
| | - Hwaseong Ryu
- Department of Radiology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Jeong A Yeom
- Department of Radiology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Jieun Roh
- Department of Radiology, Pusan National University Yangsan Hospital, Yangsan, Korea
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Sbeit W, Kadah A, Mahamid M, Mari A, Khoury T. A state-of-the-art comprehensive review summarizing the emerging data on endoscopic ultrasound-guided liver diseases management. Eur J Gastroenterol Hepatol 2021; 33:e13-e20. [PMID: 32804852 DOI: 10.1097/meg.0000000000001893] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Liver diseases are among the most common diseases worldwide accounting for substantial morbidity and mortality. Most liver diseases necessitate radiological evaluation or accurate diagnosis and recently for management as well. In the last decade, the application of therapeutic endoscopic ultrasound (EUS) procedure has been increasingly utilized for the management of various liver diseases. In this comprehensive narrative review article, we provide systematic overview on EUS-guided therapeutic interventions in various liver diseases summarizing most updated data regarding technical success, outcomes and safety profiles. Overall, 35 articles have reported on the use of EUS in the treatment of liver diseases with excellent technical success, favorable radiological response and high safety profiles for EUS-guided treatment of solid and cystic liver lesion and for EUS-guided angiotherapy for gastric varices, except for EUS-guided cyanoacrylate glue injection which was associated with life-threatening fatal systemic embolization adverse events. This suggests that EUS-guided intervention is a new promising therapeutic intervention for the treatment of various liver diseases with durable effect and a limited potential for adverse events.
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Affiliation(s)
- Wisam Sbeit
- Department of Gastroenterology, Galilee Medical Center, Nahariya
- Faculty of Medicine in the Galilee, Bar-Ilan University, Safed
| | - Anas Kadah
- Department of Gastroenterology, Galilee Medical Center, Nahariya
- Faculty of Medicine in the Galilee, Bar-Ilan University, Safed
| | - Mahmud Mahamid
- Gastroenterology Department, Sharee Zedek Medical Center, Jerusalem
| | - Amir Mari
- Gastroenterology and Endoscopy Units, The Nazareth Hospital, EMMS, Nazareth
- Faculty of Medicine in the Galilee, Bar-Ilan University, Safed, Israel
| | - Tawfik Khoury
- Department of Gastroenterology, Galilee Medical Center, Nahariya
- Faculty of Medicine in the Galilee, Bar-Ilan University, Safed
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Zhou G, Li S, Jiang M, Zhou W, Yin J. Comparison of polidocanol sclerotherapy with laparoscopic deroofing in the management of pediatric symptomatic simple renal cysts: A long-term study. J Endourol 2021; 36:99-103. [PMID: 34269606 DOI: 10.1089/end.2021.0142] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE To compare the efficacy and safety of percutaneous polidocanol sclerotherapy and laparoscopic deroofing in the management of pediatric symptomatic simple renal cysts. METHODS Forty-six patients with symptomatic simple renal cysts (cyst size ≥ 4 cm) were treated either with polidocanol sclerotherapy (group A) or by laparoscopic deroofing (group B) between December 2009 and October 2019. The patients were re-evaluated at 1, 6, and 12 months and annually thereafter. RESULTS Twenty-one patients were treated with polidocanol sclerotherapy (group A) and 25 patients with laparoscopic deroofing (group B). The mean follow-up period was 58.7 months (14-107) in group A and 57.2 months (12-118) in group B. Complete regression was seen in 19 (90.5%) and 24 (96%) patients in groups A and B, respectively (p<0.05). Partial regression was documented in one patient each in group A (4.8%) and B (4%). In one group A patient, a laparoscopic deroofing was performed due to sclerotherapy failure after 27 months. The operation time, postoperative hospital stay, and cost were significantly less in group A than in group B (36.3±8.4 vs. 96.9±19.1, 19.7±2.4 vs. 56.0±8.6, and ¥8173±1343 vs. ¥14119±2021, respectively; p < 0.05). CONCLUSION Polidocanol sclerotherapy and laparoscopic deroofing were found to be equally effective interventions associated with minimal complications for pediatric symptomatic simple renal cysts. We recommend polidocanol sclerotherapy as the first option for children with symptomatic simple renal cysts and laparoscopic deroofing in cases of failed polidocanol sclerotherapy.
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Affiliation(s)
| | | | | | | | - Jianchun Yin
- Shenzhen Children's Hospital, 85113, urology, Department of Urology and Laboratory of Pelvic Floor Muscle Function, Shenzhen Children's Hospital, Futian District, Shenzhen 518000, Guangdong, P.R.China, Shenzhen, China, 518038;
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Soleimanzadeh F, Tahmasbi F, Jahantabi E, Ebrahimi Hariri S, Amjadi M. Percutaneous drainage with the injection of ethanol as the sclerosing agent for treatment of simple kidney cysts: A new modification. J Endourol 2021; 35:1439-1442. [PMID: 33823615 DOI: 10.1089/end.2020.1158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Simple kidney cysts are the most common type of benign kidney tumors in adults and they are usually asymptomatic. Symptomatic cysts are treated with percutaneous aspiration with or without sclerosing agent injection, laparoscopic decortication or with open surgery in rare cases. Considering the probable complications of anesthesia in open surgery and laparoscopic methods, we tend use an innovative method by percutaneous aspiration, inserting nephrostomy catheter for 24 hours and injection of sclerosing agents, leaving the agent inside the cyst while catheter is removed immediately. Long term results of this method were evaluated using sonography. METHOD AND MATERIALS Twenty-eight patients with symptomatic kidney cysts underwent the process of inserting the percutaneous catheter and aspiration of its contents in two steps and one-time injection of 95% ethanol. After the first aspiration, patients stayed admitted for 24 hours. Then, the second aspiration was performed and the total fluid volume was measured. Patients were then followed for a mean follow-up period of 14 months. The success of the procedure was considered as no signs of relapse (consistent with reduced size of the cysts) in sonographic evaluation of long-term results. RESULTS Among all the patients, 23 (82.14%) showed positive results in sonographic evaluation after 14 months. Death occurred in one patient (3.6%) not attributable to the procedure and recurrence was seen in 5 patients (17.9%). CONCLUSION Our study showed that this method is safe, effective and minimally invasive in treating simple kidney cysts and can be a proper substitute for the other current methods.
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Affiliation(s)
- Farzin Soleimanzadeh
- Tabriz University of Medical Sciences, 48432, Urology Department, Tabriz, East Azerbaijan, Iran (the Islamic Republic of);
| | - Fateme Tahmasbi
- Tabriz University of Medical Sciences, 48432, Student Research Committee, Golgasht, Tabriz University of Medical Science, Tabriz, IRAN (ISLAMIC REPUBLIC OF), Iran (the Islamic Republic of), 516573669;
| | - Elham Jahantabi
- Tabriz University of Medical Sciences, 48432, Urology Department, Tabriz, East Azerbaijan, Iran (the Islamic Republic of);
| | - Soheil Ebrahimi Hariri
- Tabriz University of Medical Sciences, 48432, Urology Department, Tabriz, East Azerbaijan, Iran (the Islamic Republic of);
| | - Mohsen Amjadi
- Tabriz University of Medical Sciences, 48432, Urology Department, Tabriz, East Azerbaijan, Iran (the Islamic Republic of);
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Comba C, Salik AE, Demirayak G, Erdogan SV, Sacan F, Ozdemir IA. Comparison of Postoperative Benign Pelvic Cysts Occurred after Gynecologic or Gyne-oncologic Surgery Treated with Percutaneous Transcatheteric Sclerosant Alcohol Therapy. Gynecol Minim Invasive Ther 2020; 9:198-203. [PMID: 33312862 PMCID: PMC7713659 DOI: 10.4103/gmit.gmit_107_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Revised: 04/16/2019] [Accepted: 06/15/2020] [Indexed: 11/24/2022] Open
Abstract
Objectives: Here, we compare the success of percutaneous transcatheter sclerosant alcohol therapy (PTSAT) for the postoperative treatment of benign pelvic cysts that occurred after gynecologic surgery. Materials and Methods: The study is a retrospective case–control trial. Gynecological patients who had symptoms due to postoperative pelvic cysts and received PTSAT after gynecologic surgery, between October 2008 and January 2018, were examined in a single training and research hospital in Turkey. Some factors were investigated for associations with postoperative pelvic cyst formation in patients who underwent gynecologic operations for malignancies or benign conditions. Statistical analysis used: The association between two independent and nonnormally distributed continuous variables was analyzed with the Mann–Whitney U-test. Spearman's rho correlation analysis was conducted to determine the correlation of two nonnormally distributed variables. Chi-square (or Fisher's exact test, when more suitable) was used to examine the correlation between categorical variables. Results: Statistically significant differences were found in terms of the average age was higher in patients with malignancies, and the average postoperative pelvic cyst detection time was higher in patients with benign pelvic cysts. While all patients were treated with PTSAT, repetitive PTSAT was required for seven benign and ten malign cases. Conclusion: Patients with pelvic cysts that occurred after gynecologic surgery for malignant conditions, large volume pelvic cysts and patients with benign cysts who underwent more than one surgery required recurrent PTSAT.
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Affiliation(s)
- Cihan Comba
- Department of Gynecology and Obstetrics, Division of Gynecologic Oncology, University of Health Sciences, Sultangazi Haseki Training and Research Hospital, Istanbul, Turkey
| | - Aysun Erbahceci Salik
- Department of Interventional Radiology, University of Health Sciences, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Gokhan Demirayak
- Department of Gynecology and Obstetrics, Division of Gynecologic Oncology, University of Health Sciences, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Sakir Volkan Erdogan
- Department of Gynecology and Obstetrics, University of Health Sciences, Bagcilar Training and Research Hospital, Istanbul, Turkey
| | - Filiz Sacan
- Department of Interventional Radiology, Acıbadem Altunizade Hospital, Istanbul, Turkey
| | - Isa Aykut Ozdemir
- Department of Gynecology and Obstetrics, Division of Gynecologic Oncology, Medipol Mega University Hospital, Istanbul, Turkey
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Bertog S, Sharma A, Mahfoud F, Pathak A, Schmieder RE, Sievert K, Papademetriou V, Weber MA, Haratani N, Lobo MD, Saxena M, Kandzari DE, Fischell TA, Sievert H. Alcohol-Mediated Renal Sympathetic Neurolysis for the Treatment of Hypertension: The Peregrine™ Infusion Catheter. CARDIOVASCULAR REVASCULARIZATION MEDICINE 2020; 24:77-86. [PMID: 32958438 DOI: 10.1016/j.carrev.2020.09.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 08/15/2020] [Accepted: 09/01/2020] [Indexed: 01/12/2023]
Abstract
Renal sympathetic denervation using conventional non-irrigated radiofrequency catheters has potential technical shortcomings, including limited penetration depth and incomplete circumferential nerve damage, potentially impacting therapeutic efficacy. Against this background, second generation multi-electrode, radiofrequency and ultrasound renal denervation systems have been developed to provide more consistent circumferential nerve ablation. Irrigated catheters may allow deeper penetration while minimizing arterial injury. In this context, catheter-based chemical denervation, with selective infusion of alcohol, a potent neurolytic agent, into the perivascular space, may minimize endothelial, intimal and medial injury while providing circumferential neurolysis. Animal studies demonstrate pronounced renal norepinephrine level reductions and consistent renal nerve injury after perivascular alcohol infusion using the Peregrine Catheter. Early clinical studies demonstrated significant blood pressure reductions and a reasonable safety profile. Randomized sham-controlled trials (NCT03503773, NCT02910414) are underway to examine whether the aforementioned theoretical advantages of alcohol-medicated denervation with the Peregrine System™ Kit translate into clinical benefits.
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Affiliation(s)
- Stefan Bertog
- CardioVascular Center Frankfurt, Frankfurt, Germany; Minneapolis Veterans Affairs Medical Center, Minneapolis, USA
| | - Alok Sharma
- Minneapolis Veterans Affairs Medical Center, Minneapolis, USA
| | - Felix Mahfoud
- Saarland University Hospital, Internal Medicine III, Cardiology, Angiology, Intensive Care Medicine, Homburg/Saar, Germany; Institute of Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Atul Pathak
- Department of Cardiovascular Medicine, Princess Grace Hospital, Monaco
| | - Roland E Schmieder
- University Hospital of the Friedrich Alexander University Erlangen-Nürnberg, Germany
| | - Kolja Sievert
- CardioVascular Center Frankfurt, Frankfurt, Germany; Johannes Gutenberg Universität, Mainz, Germany
| | | | | | | | - Melvin D Lobo
- Barts NIHR Biomedical Research Centre, William Harvey Research Institute, Queen Mary University, London, UK
| | - Manish Saxena
- Barts NIHR Biomedical Research Centre, William Harvey Research Institute, Queen Mary University, London, UK
| | | | | | - Horst Sievert
- CardioVascular Center Frankfurt, Frankfurt, Germany; Anglia Ruskin University, Chelmsford, UK.
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Using Polidocanol in Treatment of Simple Renal Cyst. Indian J Surg 2020. [DOI: 10.1007/s12262-019-01964-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Belgrano E, Carmignani G, Puppo P, Quattrini S, Trombetta C. La Puntura Di Cisti Renali: Valutazione Di Una Teenica Sulla Base Di Sette Anni Di Esperienza. Urologia 2018. [DOI: 10.1177/039156038305000223] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Mancini V, Cormio L, d'Altilia N, Benedetto G, Ferrarese P, Balzarro M, Defidio L, Carrieri G. Retrograde Intrarenal Surgery for Symptomatic Renal Sinus Cysts: Long-Term Results and Literature Review. Urol Int 2018; 101:150-155. [PMID: 29719301 DOI: 10.1159/000488685] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Accepted: 03/21/2018] [Indexed: 11/19/2022]
Abstract
INTRODUCTION To report the long-term multicenter experience with retrograde intrarenal holmium-laser incision (RIR-HoLI) in the management of symptomatic renal sinus cysts (RSCs). In the literature, RIR-HoLI has been shown to be a safe and effective treatment, but there are only a few reports regarding long-term results and reproducibility of this procedure. MATERIAL AND METHODS From June 2010 to June 2015, 14 patients with symptomatic RSCs underwent RIR-HoLI. The mean age was 52.1 ± 11.28 years (range 28-77) and the mean cyst size was 53.2 ± 14.23 mm (range 35-90). In all cases, contrast-enhanced computer tomography (CT) showed compression of the renal pelvis by the cyst (no malignancy). Surgical outcome was assessed in terms of symptoms improvement (measured by Visual Analogue Scale [VAS] for pain) and renal ultrasound findings at 3-6-12 months postoperatively and then yearly. CT scan was carried out at 12 months follow-up. RESULTS RIR-HoLI was successful in all patients. The mean operative time was 47.8 ± 13.54 min (range 30-80) and mean hospital stay was 3.5 days (range 2-5). There were 2 Clavien grade II complications (flank pain and urgency delaying discharge). After surgery, all patients -became asymptomatic (VAS score change, p = 0.0001). One patient had persistence of a small cyst (10 mm). Mean follow-up is 44 ± 17.24 months (range 24-84); all patients remained asymptomatic, with no signs of recurrence. CONCLUSIONS RIR-HoLI proved to be a safe and effective treatment for symptomatic RSCs. In our experience, it provided excellent long-term results and was reproducible at 4 different -institutions.
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Affiliation(s)
- Vito Mancini
- Department of Urology and Renal Transplantation, University of Foggia, Foggia, Italy
| | - Luigi Cormio
- Department of Urology and Renal Transplantation, University of Foggia, Foggia, Italy
| | - Nicola d'Altilia
- Department of Urology and Renal Transplantation, University of Foggia, Foggia, Italy
| | - Giuseppe Benedetto
- Department of Urology, San Bortolo Hospital, ULSS 8 Berica, Vicenza, Italy
| | - Paolo Ferrarese
- Department of Urology, San Bortolo Hospital, ULSS 8 Berica, Vicenza, Italy
| | | | | | - Giuseppe Carrieri
- Department of Urology and Renal Transplantation, University of Foggia, Foggia, Italy
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Hassoun J, Ortega G, Burkhalter LS, Josephs S, Qureshi FG. Management of nonparasitic splenic cysts in children. J Surg Res 2018; 223:142-148. [DOI: 10.1016/j.jss.2017.09.036] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Revised: 08/18/2017] [Accepted: 09/28/2017] [Indexed: 11/27/2022]
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Zhang WY, Jin ZD, Liu F, Yuan HH, Jiang B. Antitumor Activity of Intratumoral Ethanol Injection in an Orthotopic Pancreatic Cancer Cell Mouse Xenograft Model. Gastroenterol Res Pract 2018; 2018:7149565. [PMID: 29675041 PMCID: PMC5841100 DOI: 10.1155/2018/7149565] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Revised: 01/16/2018] [Accepted: 01/22/2018] [Indexed: 01/01/2023] Open
Abstract
PURPOSE Pancreatic cancer is a lethal disease and usually is diagnosed at advanced stages of disease. This study assessed the effects of intratumoral ethanol injection using an endoscopic ultrasound (EUS) probe on the control of pancreatic cancer in a mouse orthotopic xenograft model. MATERIALS AND METHODS The subcutaneous and orthotopic human pancreatic cancer cell mouse xenograft models were established. Different concentrations of ethanol (0-95%) were injected into subcutaneous xenograft tumors. In the orthotopic tumor model, ethanol was injected into the tumor lesions under the guidance of a high-frequency EUS probe. Tumor volume, relative tumor volume (RTV), and histopathology were evaluated. The serum amylase level was analyzed at baseline and 24 h after treatment in the orthotopic tumor model. RESULTS Injection of 40-95% ethanol induced tumor necrosis in the subcutaneous tumor model, while there was no statistical difference between the RTVs of the two groups (P = 0.81). In the orthotopic tumor model, the RTV of the 80% ethanol treatment group was less than that of the saline injection group (P < 0.01); and histologically, there was a large area of necrosis observed in the 80% ethanol group. The serum amylase level was slightly elevated at 24 h after injection and returned to the baseline level at 7 days. CONCLUSION Injection of 80% ethanol into xenograft tumor lesions of orthotopic pancreatic cancer resulted in tumor necrosis, and the procedure was safe and effective. Future studies will further confirm its antitumor activity as well as assess its safety and feasibility.
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Affiliation(s)
- Wen-Ying Zhang
- Department of Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Zhen-Dong Jin
- Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, China
| | - Feng Liu
- Department of Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Hai-Hua Yuan
- Department of Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Bin Jiang
- Department of Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, Shanghai, China
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Dietrich CF, Müller T, Bojunga J, Dong Y, Mauri G, Radzina M, Dighe M, Cui XW, Grünwald F, Schuler A, Ignee A, Korkusuz H. Statement and Recommendations on Interventional Ultrasound as a Thyroid Diagnostic and Treatment Procedure. ULTRASOUND IN MEDICINE & BIOLOGY 2018; 44:14-36. [PMID: 29126752 DOI: 10.1016/j.ultrasmedbio.2017.08.1889] [Citation(s) in RCA: 76] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Revised: 08/24/2017] [Accepted: 08/29/2017] [Indexed: 06/07/2023]
Abstract
The recently published guidelines of the European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB) on interventional ultrasound (INVUS)-guided procedures summarize the intended interdisciplinary and multiprofessional approach. Herewith, we report on recommendations for interventional procedures for diagnosis and treatment of the thyroid gland.
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Affiliation(s)
- Christoph F Dietrich
- Medizinische Klinik 2, Caritas Krankenhaus, Bad Mergentheim, Germany; Ultrasound Department, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
| | - Thomas Müller
- Medizinische Klinik I, Klinikum am Steinenberg, Reutlingen, Germany
| | - Jörg Bojunga
- 1st Medical Department, Johann Wolfgang Goethe Universitätsklinikum, Frankfurt, Germany
| | - Yi Dong
- Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Giovanni Mauri
- Division of Interventional Radiology, European Institute of Oncology, Milan, Italy
| | - Maija Radzina
- Diagnostic Radiology Institute, Paula Stradina Clinical University Hospital, Riga, Latvia
| | - Manjiri Dighe
- Department of Radiology, University of Washington, Seattle, Washington, USA
| | - Xin-Wu Cui
- Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Frank Grünwald
- Department of Nuclear Medicine, Johann Wolfgang Goethe Universitätsklinikum, Frankfurt, Germany; German Center for Thermoablation of Thyroid Nodules, University Hospital Frankfurt, Frankfurt, Germany
| | - Andreas Schuler
- Zentrum für Innere Medizin, Alb Fils Kliniken, Helfenstein Klinik, Germany
| | - Andre Ignee
- Medizinische Klinik 2, Caritas Krankenhaus, Bad Mergentheim, Germany
| | - Huedayi Korkusuz
- Department of Nuclear Medicine, Johann Wolfgang Goethe Universitätsklinikum, Frankfurt, Germany; German Center for Thermoablation of Thyroid Nodules, University Hospital Frankfurt, Frankfurt, Germany
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15
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Cavalieri J, Hayes L. Examination of the use of intraovarian administration of CaCl2
and zinc gluconate as potential chemosterilants in Bos indicus
heifers. Aust Vet J 2017; 95:403-415. [DOI: 10.1111/avj.12644] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2016] [Revised: 02/02/2017] [Accepted: 02/12/2017] [Indexed: 11/30/2022]
Affiliation(s)
- J Cavalieri
- College of Public Health, Medical and Veterinary Sciences; James Cook University; Townsville Queensland 4811 Australia
| | - L Hayes
- College of Public Health, Medical and Veterinary Sciences; James Cook University; Townsville Queensland 4811 Australia
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16
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Koklu S, Basar O, Brugge WR. Endoscopic ultrasound guided tumor directed therapy and cyst ablation. TECHNIQUES IN GASTROINTESTINAL ENDOSCOPY 2017. [DOI: 10.1016/j.tgie.2017.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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17
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Lai S, Xu X, Diao T, Jiao B, Jiang Z, Zhang G. The efficacy of retroperitoneal laparoscopic deroofing of simple renal cyst with perirenal fat tissue wadding technique: A retrospective study. Medicine (Baltimore) 2017; 96:e8259. [PMID: 29019896 PMCID: PMC5662319 DOI: 10.1097/md.0000000000008259] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Treatment options for simple renal cyst (SRC) include open surgery, laparoscopy with decortication, or percutaneous aspiration with or without sclerotherapy. Though laparoscopic unroofing achieves better results than percutaneous sclerotherapy, the reported recurrence rate is still up to 19%. Thus, it is necessary to find methods to reduce the recurrence rate.To investigate whether the perirenal pedicled fat tissue wadding technique during retroperitoneal laproscopic deroofing (RLD) of SRC affects the incidence of recurrence.A retrospective analysis was carried out on clinical data of 254 patients with SRC treated by RLD in our hospital from 2008 to 2016. Among these patients,119 had a simple retroperitoneal deroofing (SRD) and 135 received a retroperitoneoscopic deroofing with wadding of the cyst using perirenal fat tissue (RDCW). The recurrence rate and variables, as well as perioperative complications, were compared. To further explore the potential variables influencing cyst recurrence rate, univariate and multivariate regression analyses were applied.A total of 251 patients were included in the analysis. The operation was successfully completed laparoscopically in all cases with no conversion to open surgery. No mortality or significant complication occurred in both groups. After a median follow-up of 38.67 months, we noted 41 recurrences. According to the univariate and multivariate regression analyses, patients managed with the wadding technique had superior recurrence-free survival (RFS), compared with patients in SRD group (log-rank P = .03 and P = .04, respectively). Moreover, patients with single renal cyst had a lower recurrence rate, compared with patients with multiple renal cysts (log-rank P < .01). Regarding the operation time, blood loss, and hospital stay, no statistically significant difference was found between 2 groups (P values .13, .30, and .75, respectively). However, less postoperative drainage and shorter postoperative interval until tube removal (P = .04) were observed in RDCW group.The perirenal pedicled fat tissue wadding technique can decrease the cyst recurrence rate and RCDW represents an effective and safe treatment option in the management of renal cysts.
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Affiliation(s)
- Shicong Lai
- Peking University China-Japan Friendship School of Clinical Medicine
- Department of Urology, China-Japan Friendship Hospital, Beijing
| | - Xin Xu
- Department of Urology, China-Japan Friendship Hospital, Beijing
| | - Tongxiang Diao
- Peking University China-Japan Friendship School of Clinical Medicine
- Department of Urology, China-Japan Friendship Hospital, Beijing
| | - Binbin Jiao
- Peking University China-Japan Friendship School of Clinical Medicine
- Department of Urology, China-Japan Friendship Hospital, Beijing
| | - Zhaoqiang Jiang
- Department of Urology, Henan Provincial People's Hospital, Zhengzhou, Henan Province, China
| | - Guan Zhang
- Peking University China-Japan Friendship School of Clinical Medicine
- Department of Urology, China-Japan Friendship Hospital, Beijing
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18
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Akhan O, Dagoglu-Kartal MG, Ciftci T, Ozer C, Erbahceci A, Akinci D. Percutaneous Treatment of Non-parasitic Splenic Cysts: Long-Term Results for Single- Versus Multiple-Session Treatment. Cardiovasc Intervent Radiol 2017; 40:1421-1430. [PMID: 28462445 DOI: 10.1007/s00270-017-1650-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2016] [Accepted: 04/04/2017] [Indexed: 11/29/2022]
Abstract
PURPOSE The aim of this study was to investigate the efficacy and safety of percutaneous sclerotherapy for non-parasitic splenic cysts (NPSCs). The secondary aims were to introduce puncture-aspiration-injection-reaspiration (PAIR) technique in the treatment of NPSCs and to compare multiple- and single-session techniques. MATERIALS AND METHODS This retrospective study included 24 (17 females, 7 males) patients, treated between the years 1997 and 2015. Three techniques were used. Group A (n = 8), Group B (n = 6) and Group C (n = 10) were treated by PAIR, single-session catheterization and multiple-session catheterization, respectively. Since both PAIR and single-session catheterization techniques are carried out in a single session, Group A and Group B were evaluated in one group (Group A + B). Group A + B was compared with Group C in terms of patient demographics, the initial volume of the cysts, follow-up periods, complication and hospitalization rates and follow-up results. Recurrence and reduction rates were evaluated for two groups. RESULTS Technical success rate was 100%. The mean follow-up period was 68.9 months. Recurrence detected in 7 (29.1%) patients. Final reduction rate was between 40.7 and 100% (median 96.4%) with a significant difference in cyst volume (p < 0.05). There was no significant difference regarding recurrence rates (p = 1) and the final reduction rates (p = 0.51) between the two groups. CONCLUSION Percutaneous sclerotherapy is a minimally invasive technique, preserving maximum tissue while effectively treating NPSCs. Single-session sclerotherapy which reduces hospitalization days and increases patient comfort is as effective as multi-session sclerotherapy as the initial procedure. This study supports that single-session sclerotherapy should be a valid treatment option.
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Affiliation(s)
- Okan Akhan
- Department of Radiology, Hacettepe University School of Medicine, 6100, Sihhiye, Ankara, Turkey.
| | | | - Turkmen Ciftci
- Department of Radiology, Hacettepe University School of Medicine, 6100, Sihhiye, Ankara, Turkey
| | - Cigdem Ozer
- Numune Training and Research Hospital Radiology Clinic, Ülkü Mahallesi Talatpaşa Bulvari No: 5, Altindag, 6080, Ankara, Turkey
| | - Aysun Erbahceci
- Sadi Konuk Training and Research Hospital Radiology Clinic, Tevfik Saglam Caddesi No: 11, Zuhuratbaba, 34147, Istanbul, Turkey
| | - Devrim Akinci
- Department of Radiology, Hacettepe University School of Medicine, 6100, Sihhiye, Ankara, Turkey
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Signoretti M, Valente R, Repici A, Delle Fave G, Capurso G, Carrara S. Endoscopy-guided ablation of pancreatic lesions: Technical possibilities and clinical outlook. World J Gastrointest Endosc 2017; 9:41-54. [PMID: 28250896 PMCID: PMC5311472 DOI: 10.4253/wjge.v9.i2.41] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Revised: 10/12/2016] [Accepted: 12/09/2016] [Indexed: 02/05/2023] Open
Abstract
Endoscopic ultrasound (EUS) and endoscopic retrograde cholangiopancreatography (ERCP)-guided ablation procedures are emerging as a minimally invasive therapeutic alternative to radiological and surgical treatments for locally advanced pancreatic cancer (LAPC), pancreatic neuroendocrine tumours (PNETs), and pancreatic cystic lesions (PCLs). The advantages of treatment under endoscopic control are the real-time imaging guidance and the possibility to reach a deep target like the pancreas. Currently, radiofrequency probes specifically designed for ERCP or EUS ablation are available as well as hybrid cryotherm probe combining radiofrequency with cryotechnology. To date, many reports and case series have confirmed the safety and feasibility of that kind of ablation technique in the pancreatic setting. Moreover, EUS-guided fine-needle injection is emerging as a method to deliver ablative and anti-tumoral agents inside the tumuor. Ethanol injection has been proposed mostly for the treatment of PCLs and for symptomatic functioning PNETs, and the use of gemcitabine and paclitaxel is also interesting in this setting. EUS-guided injection of chemical or biological agents including mixed lymphocyte culture, oncolytic viruses, and immature dendritic cells has been investigated for the treatment of LAPC. Data on the long-term efficacy of these approaches, and large prospective randomized studies are needed to confirm the real clinical benefits of these techniques for the management of pancreatic lesions.
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Bas O, Nalbant I, Can Sener N, Firat H, Yeşil S, Zengin K, Yalcınkaya F, Imamoglu A. Management of renal cysts. JSLS 2016; 19:e2014.00097. [PMID: 25848184 PMCID: PMC4376217 DOI: 10.4293/jsls.2014.00097] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background and Objectives: Renal cysts have a high prevalence in the general population, and their estimated incidence increases with age. Renal cyst aspiration (usually with sclerotherapy) or open/laparoscopic decortication is a generally effective and safe method in the treatment of symptomatic simple renal cysts. The success rates of laparoscopic decortication and percutaneous aspiration-sclerotherapy were compared to assist in the decision making for the procedure. Methods: A total of 184 patients with symptomatic simple renal cysts were treated with either laparoscopic decortication in 149 cases or percutaneous aspiration-sclerotherapy in 35 cases. The follow-up period was approximately 35 months, and the symptomatic and radiologic success rates of the 2 techniques were compared retrospectively. Results: Laparoscopic decortication was found to have high success rates, a low recurrence rate, and minimal morbidity. Percutaneous aspiration-sclerotherapy is an outpatient procedure with a minimally higher recurrence rate. Conclusion: When a symptomatic cyst is encountered and treatment of the cyst is indicated, laparoscopic decortication is a more efficient method that offers better results than percutaneous aspiration-sclerotherapy.
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Affiliation(s)
- Okan Bas
- Department of Urology, Abdurrahman Yurtaslan Oncology Education and Research Hospital, Ministry of Health, Ankara, Turkey
| | - Ismail Nalbant
- Department of Urology, Yenimahalle State Hospital, Ministry of Health, Ankara, Turkey
| | - Nevzat Can Sener
- Department of Urology, Numune Education and Research Hospital, Ministry of Health, Adana, Turkey
| | - Hacer Firat
- Department of Radiology, Diskapi Yildirim Beyazid Education and Research Hospital, Ministry of Health, Ankara, Turkey
| | - Süleyman Yeşil
- Department of Urology, Gazi University School of Medicine, Ankara, Turkey
| | - Kürşad Zengin
- Department of Urology, Bozok University School of Medicine, Yozgat, Turkey
| | - Fatih Yalcınkaya
- Department of Urology, Diskapi Yildirim Beyazid Education and Research Hospital, Ministry of Health, Ankara, Turkey
| | - Abdurrahim Imamoglu
- Department of Urology, Diskapi Yildirim Beyazid Education and Research Hospital, Ministry of Health, Ankara, Turkey
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Cho YJ, Shin JH. Comparison of acetic acid and ethanol sclerotherapy for simple renal cysts: clinical experience with 86 patients. SPRINGERPLUS 2016; 5:299. [PMID: 27066335 PMCID: PMC4783315 DOI: 10.1186/s40064-016-1971-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2015] [Accepted: 03/03/2016] [Indexed: 11/10/2022]
Abstract
Background
To compare the efficacy and treatment session numbers of acetic acid to that of ethanol sclerotherapy for the treatment of simple renal cysts. Between February 2004 and June 2013, 86 patients with simple renal cysts underwent percutaneous aspiration and injection of 50 %-acetic-acid (42 cysts) and 95 %-ethanol (44 cysts). The patient demographics, volume reduction rate, number of treatment sessions, and complications were then analyzed. Results The volume reduction rate was 94.1 ± 7.6 % in the 50 %-acetic acid group and 94.7 ± 11.7 % in the 95 %-ethanol group, and without a statistical difference. The rates of complete remission, partial remission, and no response were 57.1, 42.9 and 0 %, respectively, for the acetic acid group, and 70.5, 25.0, and 4.5 %, respectively, for the ethanol group. No statistical difference was observed between the two groups. Compared to the acetic acid group, the ethanol group had a higher number of treatment sessions, i.e. 1.10 ± 0.30 in the acetic acid group and 1.80 ± 0.79 in the ethanol group. Mild flank pain was a minor complication that occurred in both groups. Conclusions Acetic acid seems to have equivalent sclerosing effects on simple renal cysts compared with those of ethanol despites of fewer treatment sessions.
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Affiliation(s)
- Young Jun Cho
- Department of Radiology, Busan Paik Hospital, Inje University College of Medicine, 633-165 Gaegeum-dong, Busanjin-gu, Busan, 614-725 Korea
| | - Ji Hoon Shin
- Department of Radiology, Asan Medical Center, Research Institute of Radiology, University of Ulsan College of Medicine, 388-1, Pungnap-2dong, Songpa-gu, Seoul, 138-736 Korea
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Yang X, Yu J, Liang P, Yu X, Cheng Z, Han Z, Liu F. Ultrasound-guided percutaneous ethanol ablation for primary non-parasitic splenic cysts in 15 patients. Abdom Radiol (NY) 2016; 41:538-44. [PMID: 27039325 DOI: 10.1007/s00261-015-0584-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
PURPOSE This study aimed to evaluate the feasibility, safety, and efficacy of ultrasound (US)-guided percutaneous ethanol ablation (PEA) for primary non-parasitic splenic cysts. MATERIALS AND METHODS Between February 2006 and February 2015, 15 patients (4 men and 11 women; mean age, 33 ± 15.3 years; age range, 17-65 years) with primary non-parasitic splenic cysts were treated with US-guided PEA. 99.5% absolute ethanol in an amount of approximately 50%-100% of the aspirated volume was injected into each cyst and no more than 240 mL. Standard laboratory tests (hemogram, coagulation, serum, and biochemical tumor marker levels) were performed before and after PEA. RESULTS The median follow-up time was 18.7 months (range 2.8-59.2 months). During follow-up, seven cysts after treatment had disappeared completely, while the other eight cysts had decreased significantly in size. The 3-, 6-, 12-, and 24-month volume reduction rates were 49.7%, 87.6%, 94.3%, and 96.7%. Serum tumor marker CA19-9 levels significantly decreased. Mild adverse reactions included moderate pain in four (26.7%), unbearable pain in one (6.67%), fever in two (13.3%) and slight intracystic bleeding in one (6.67%). There were no serious complications. CONCLUSION US-guided PEA appears to be a safe and effective minimally invasive technique for management of primary non-parasitic splenic cysts.
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Affiliation(s)
- Xiaohuan Yang
- Department of Interventional Ultrasound, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China
| | - Jie Yu
- Department of Interventional Ultrasound, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China
| | - Ping Liang
- Department of Interventional Ultrasound, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China.
| | - Xiaoling Yu
- Department of Interventional Ultrasound, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China
| | - Zhigang Cheng
- Department of Interventional Ultrasound, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China
| | - Zhiyu Han
- Department of Interventional Ultrasound, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China
| | - Fangyi Liu
- Department of Interventional Ultrasound, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China
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Ali TA, Abdelaal MA, Enite A, Badran YA. Ultrasound-guided percutaneous sclerotherapy of simple renal cysts with n-butyl cyanoacrylate and iodized oil mixture as an outpatient procedure. Urol Ann 2016; 8:51-5. [PMID: 26834402 PMCID: PMC4719512 DOI: 10.4103/0974-7796.162216] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Objective: The aim of this study was to evaluate the efficacy and safety of ultrasound guided percutaneous sclerotherapy of symptomatic simple renal cysts with n-butyl cyanoacrylate (NBCA) and iodized oil mixture as an outpatient single session procedure. Materials and Methods: A total of ninety two patients with 100 symptomatic simple renal cysts (larger than 5 cm) were treated by ultrasound (US)-guided percutaneous aspiration and injection of NBCA and iodized oil mixture. The patients (68 men and 24 women, mean age, 42.4 ± 10.5 years) were treated with as out-patients. The volume of the treated cysts was calculated with periodic noncontrast enhanced CT examinations 3, 6 and 9, months after the procedure. The procedure was considered successful at follow-up CT when there was total ablation or greater than 80% reduction of size with resolution of symptoms, respectively. Failure was defined as less than 80% reduction and/or persistent symptoms. Results: The sclerotherapy was technically successful in all patients. The diameter of the cysts ranged between 5.5 and 13.5 cm (mean, 8.8 ± 1.4 cm), and 1.5 and 3.8 cm (mean, 2.1 ± 0.4 cm) before and after sclerotherapy, respectively (P < 0.001). Average diameter reduction was 83.7% during the follow-up period. The mean follow- up lasted 7.1 months (3–11 months). Flank pain resolved in 86 of 92 symptomatic patients (93.48%). In six patients, the symptoms decreased slightly. The procedure was successful in 98 of 100 cysts (98%), demonstrated by follow-up CT. The only two failed cyst was larger than 10 cm in diameter and don’t required any further treatment. We did not observe any procedure related complications. Conclusion: Ultrasound guided percutaneous sclerotherapy with NBCA and iodized oil mixture for management of symptomatic simple renal cysts was found to be a real time, effective, safe, well tolerated, alternative and simple technique that can be carried out by urologists as an outpatient procedure.
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Affiliation(s)
- Tamer A Ali
- Department of Urology, Al-Azhar Faculty of Medicine, Cairo, Egypt
| | | | - Ashraf Enite
- Department of Radiology, Al-Azhar Faculty of Medicine, Cairo, Egypt
| | - Yasser A Badran
- Department of Urology, Al-Azhar Faculty of Medicine, Cairo, Egypt
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Gaur D, Agarwal D, Purohit K, Darshane A, Saxena V. Retroperitoneal laparoscopic decortication of renal cysts: an initial report. MINIM INVASIV THER 2016. [DOI: 10.1080/0961625x.1994.11665541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Mun SW, Lim TJ, Hwang EH, Lee YJ, Jeon UB, Park JH. A Case of Post-Traumatic Pseudocyst in the Spleen Successfully Treated with Alcohol Sclerotherapy. Pediatr Gastroenterol Hepatol Nutr 2015; 18:276-9. [PMID: 26770903 PMCID: PMC4712541 DOI: 10.5223/pghn.2015.18.4.276] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Revised: 04/14/2015] [Accepted: 05/11/2015] [Indexed: 11/23/2022] Open
Abstract
This report details a case of post-traumatic pseudocyst in the spleen that was successfully treated with sclerotherapy using ethanol. A sixteen-year-old boy visited our hospital for a follow-up examination of a splenic cyst. He had experienced blunt trauma to the abdomen three years prior to presentation. An abdominal computed tomography scan revealed a large cyst of the lower pole of the spleen. The cyst was 6.8×9.5×7.0 cm and conservative management was tried. A follow-up ultrasonographic examination three years later revealed that the size of the cyst was unchanged and another treatment was needed to prevent complications. One session of sclerosis with ethanol (90 mL of 99% ethanol) percutaneously was applied to the cyst. A follow-up after four months revealed that the cyst had completely resolved.
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Affiliation(s)
- Sang Wook Mun
- Department of Pediatrics, Pusan National University School of Medicine, Yangsan, Korea
| | - Taek-Jin Lim
- Department of Pediatrics, Pusan National University School of Medicine, Yangsan, Korea
| | - Eun Ha Hwang
- Department of Pediatrics, Pusan National University School of Medicine, Yangsan, Korea
| | - Yeoun Joo Lee
- Department of Pediatrics, Pusan National University School of Medicine, Yangsan, Korea
| | - Ung Bae Jeon
- Department of Radiology, Pusan National University School of Medicine, Yangsan, Korea
| | - Jae Hong Park
- Department of Pediatrics, Pusan National University School of Medicine, Yangsan, Korea
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Ethanol Ablation of a Peripheral Nerve Sheath Tumor Presenting as a Small Bowel Obstruction. ACG Case Rep J 2015; 3:31-2. [PMID: 26504873 PMCID: PMC4612753 DOI: 10.14309/crj.2015.92] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Accepted: 06/29/2015] [Indexed: 01/12/2023] Open
Abstract
Ethanol has historically been used as an ablative agent for a variety of lesions. One of the more common applications of this technique is celiac plexus neurolysis; however, recent reports have suggested a role for the endoscopic alcohol ablation of a variety of solid and cystic lesions. We report a novel case of endoscopic ethanol ablation of a peripheral nerve sheath tumor presenting as a small bowel obstruction.
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27
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Efesoy O, Tek M, Bozlu M, Doruk HE. Comparison of single-session aspiration and ethanol sclerotherapy with laparoscopic de-roofing in the management of symptomatic simple renal cysts. Turk J Urol 2015; 41:14-9. [PMID: 26328192 DOI: 10.5152/tud.2015.77675] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2014] [Accepted: 01/05/2015] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The aim of the study was to compare the efficacy and cost-effectiveness of single-session aspiration and ethanol sclerotherapy with laparoscopic de-roofing in the management of symptomatic simple renal cysts. MATERIAL AND METHODS Between March 2010 and December 2012, patients with simple renal cysts presenting with pressure and pain symptoms were divided into two groups. In Group 1 following local anesthetic administration, single session percutaneous aspiration with 95% ethanol sclerotherapy (n=38) and in Group 2 transperitoneal laparoscopic de-roofing under general anesthesia (n=42) were performed. The data were evaluated retrospectively and demographic characteristics, duration of operation and hospitalization, complication rates, cost effectiveness, radiological and symptomatic success rates at six month- follow-up were compared between the two groups. RESULTS The mean age and gender of the patients, cyst diamater, side and localization of the cyst and indications for intervention were similar in two groups. The median course of treatment and hospitalization were signifcantly decreased in Group 1 (respectively 33 min versus 59 min and 6 hours versus 24 hours, p<0.001). As complications in Group 1 fever in two patients (5.3%) and in Group 2 bleeding requiring transfusion in one patient (2.4%) were observed (p=0.495). Total cost was calculated as $ 131.7 in Group 1 and $ 729.8 in Group 2. After the sixth month follow-up control radiological success rates were found to be signifcantly higher in Group 2, while symptomatic success rate is similar in both groups (63.2% versus 95.2%, p<0.001; 94.7% versus 97.6%, p=0.498, respectively). CONCLUSION Single-session percutaneous aspiration with alcohol sclerotherapy and laparoscopic de-roofing are safe and effective methods in the treatment of symptomatic simple renal cysts. While radiological recurrence rate was higher in single session percutaneous aspiration with alcohol sclerotherapy, however similar symptomatic recurrence rates were seen with laparoscopy. Therefore single session percutaneous aspiration combined with alcohol sclerotherapy seems to be an important option in the treatment of simple renal cysts when considering the duration of the operation, hospitalization and total costs of the process.
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Affiliation(s)
- Ozan Efesoy
- Clinic of Urology, Toros State Hospital, Mersin, Turkey
| | - Mesut Tek
- Department of Urology, Mersin University Faculty of Medicine, Mersin, Turkey
| | - Murat Bozlu
- Department of Urology, Mersin University Faculty of Medicine, Mersin, Turkey
| | - Hasan Erdal Doruk
- Department of Urology, Mersin University Faculty of Medicine, Mersin, Turkey
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Renal Embolization and Urothelial Sclerotherapy for Recurrent Obstructive Urosepsis and Intractable Haematuria from Upper Tract Urothelial Carcinoma. Cardiovasc Intervent Radiol 2015. [PMID: 26206598 DOI: 10.1007/s00270-015-1184-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Management of intractable haematuria and obstructive urosepsis from upper tract urothelial carcinoma can be problematic in patients not suitable for surgery, chemotherapy or radiotherapy. Interventional radiology techniques provide alternative approaches in this setting, such as complete kidney embolization to cease urine output, percutaneous nephrostomy, antegrade injection of sclerotherapy agents and sterilisation of the upper collecting system. Related approaches have been successfully employed to sclerose renal cysts, lymphoceles, chyluria and intractable lower tract haemorrhage. No reports of percutaneous, antegrade sclerotherapy in the upper urinary tract have previously been published. We present a case of recurrent haematuria and obstructive urosepsis caused by invasive upper tract urothelial carcinoma in a non-operative patient, which was treated with renal embolisation and percutaneous upper tract urothelial sclerotherapy.
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Kim J. Endoscopic Ultrasound-Guided Treatment of Pancreatic Cystic and Solid Masses. Clin Endosc 2015; 48:308-11. [PMID: 26240804 PMCID: PMC4522422 DOI: 10.5946/ce.2015.48.4.308] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2015] [Revised: 06/20/2015] [Accepted: 06/22/2015] [Indexed: 12/12/2022] Open
Abstract
Pancreatic tumor is one of the most difficult diseases to diagnose and treat because of its anatomical location and characteristics. Recently, there have been several innovative trials on the treatment of pancreatic tumors using endoscopic ultrasound (EUS) because it allows selective access to the difficult to reach target organ along the gastrointestinal tract and can differentiate vessels by color Doppler. Among these trials, several have investigated EUS-guided ethanol lavage with or without paclitaxel for pancreatic cystic tumors. These studies show a 33% to 79% complete resolution rate with a favorable safety profile. Compared to EUS-guided ethanol lavage for pancreatic cystic tumors, EUS-guided radiofrequency ablation is considered a less invasive treatment method for pancreatic cancer. Although there are still several difficulties and concerns about complications, one clinical study reported 72.8% feasibility with favorable safety, and therefore, we anticipate the results of ongoing studies with these new less invasive techniques.
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Affiliation(s)
- Jaihwan Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
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Mao X, Xu G, Wu H, Xiao J. Ureteroscopic management of asymptomatic and symptomatic simple parapelvic renal cysts. BMC Urol 2015; 15:48. [PMID: 26048408 PMCID: PMC4456808 DOI: 10.1186/s12894-015-0042-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2014] [Accepted: 05/21/2015] [Indexed: 12/24/2022] Open
Abstract
Background To investigate feasibility and safety of treating simple parapelvic renal cysts using flexible ureteroscopy with the Holmium laser. Methods Between February 2010 and July 2013, a total of 21 patients, aging from 29 to 71 (49.00 ± 13.23), were diagnosed with parapelvic renal cysts by ultrasonography in combination with contrast-enhanced computer tomography (CT) and intravenous urography (IVU) in the Department of Urology Surgery, People’s Hospital of the Zhejiang province. Fifteen patients were asymptomatic and 6 patients were symptomatic with flank pain. All patients underwent drainage of the cysts using flexible ureteroscopy with Holmium laser. Patients were followed up 1, 3 and 12 months after the operation. Results The intervention was successful in 20 patients and failed in 1 patient who, subsequently successfully underwent a laparoscopic cyst removal. There were no intra-operative and post-operative complications reported. The mean operation time was 27 min (range: 15 to 45 min). The mean hospital stay was 2.6 days (range: 1 to 5 days). Twenty patients were followed up until 15 months after surgery. After such ureteroscopic management, there were no renal cysts detected in 7 patients (35 %) and a reduction in size of the renal cysts was found in 13 patients (65 %). Flank pain subsided in all 6 (100 %) previously symptomatic patients. Conclusions Flexible ureteroscopy with the Holmium laser may be a feasible and effective treatment option in selected patients with simple parapelvic renal cysts. Further prospective randomized studies that compare the procedure to laparoscopic treatments are needed.
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Affiliation(s)
- XiaWa Mao
- Department of Urology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, P.R. China.
| | - Gang Xu
- Department of Urology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, P.R. China.
| | - HuiFeng Wu
- Department of Urology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, P.R. China.
| | - JiaQuan Xiao
- Department of Urology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, P.R. China.
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Kandula M, Moole H, Cashman M, Volmar FH, Bechtold ML, Puli SR. Success of endoscopic ultrasound-guided ethanol ablation of pancreatic cysts: a meta-analysis and systematic review. Indian J Gastroenterol 2015; 34:193-9. [PMID: 26108653 DOI: 10.1007/s12664-015-0575-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2015] [Accepted: 05/14/2015] [Indexed: 02/04/2023]
Abstract
BACKGROUND Endoscopic ultrasound (EUS)-guided ethanol ablation has emerged as an efficacious and safe alternative management option for pancreatic cysts. We undertook a meta-analysis and systematic review to assess the overall safety and efficacy of EUS-guided ethanol ablation of pancreatic cysts. METHOD STUDY SELECTION CRITERIA EUS-guided ethanol ablation of pancreatic cysts. DATA COLLECTION EXTRACTION Articles were searched in Medline, Pubmed, and Ovid journals. STATISTICAL METHOD Fixed and random effects models were used to calculate the pooled proportions. RESULTS Initial search identified 1,319 reference articles, in which 120 relevant articles were selected and reviewed. Data was extracted from seven studies (n = 152) of EUS-guided ethanol ablation of pancreatic cysts, which met the inclusion criteria. With EUS-guided ethanol ablation, the pooled proportion of patients with complete cyst resolution was 56.20 % (95 % CI = 48.16 to 64.08) and partial cyst resolution was 23.72 % (95 % CI = 17.24 to 30.89). Postprocedural complications after ablation were significant for abdominal pain in 6.51 % (95 % CI = 3.12 to 11.04) and pancreatitis in 3.90 % (95 % CI = 1.39 to 7.60) of the pooled percentage of patients. Publication bias calculated using Harbord-Egger bias indicator gave a value of -1.09 (95 % CI = 10.21 to 8.03, p = 0.77). The Begg-Mazumdar indicator gave a Kendall's tau b value of 0.05 (p ≥ 0.99). CONCLUSIONS EUS-guided ethanol ablation may be a safe alternative treatment modality for pancreatic cysts, with acceptable intraprocedural and postprocedural complications. However, due to the limited data available, prospective randomized controlled trials with a long follow up period are required in this area.
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Affiliation(s)
- Manasa Kandula
- Division of Internal Medicine, University of Illinois College of Medicine at Peoria, Peoria, IL, USA,
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Şimşek M, Kuloğlu T, Pala Ş, Boztosun A, Can B, Atilgan R. The effect of ethanol sclerotherapy of 5 minutes duration on cyst diameter and rat ovarian tissue in simple ovarian cysts. DRUG DESIGN DEVELOPMENT AND THERAPY 2015; 9:1341-7. [PMID: 25834392 PMCID: PMC4357612 DOI: 10.2147/dddt.s76835] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVES To examine the effect of 95% ethanol sclerotherapy (EST) administered over 5 minutes on cyst diameter and ovarian tissue in experimentally induced simple ovarian cysts in a rat model. MATERIALS AND METHODS In order to induce ovarian cysts, unilateral total salpingectomy was performed in regularly menstruating adult female Wistar albino rats (n=20) between 12 and 14 weeks of age and weighing between 200 and 220 g. One month after the procedure, the abdominal cavity was opened and 14 rats (70%) were found to have developed macroscopic cysts. Rats with macroscopic cysts (n=14) were assigned into two groups in a prospective and single-blinded manner: group 1 (G1) (n=7), control rats; and group 2 (G2) (n=7), 5-minute EST 95% group. Cyst diameter was measured and recorded for each rat. In G2, after whole cyst fluid was aspirated the cystic cavity was irrigated with 95% ethanol, approximately equal to half of the aspirated cyst volume, after which an interval of 5 minutes was allowed and same amount was re-aspirated and the abdominal cavity was closed. One month after this procedure, abdominal cavities were reopened and intra-abdominal adhesion scoring was performed in both groups. Cyst diameter was measured for each rat, and the right ovary was removed, fixed in 10% formaldehyde, and transported to the laboratory. A histologic assessment of the ovarian tissues was performed under light microscopy following staining with hematoxylin and eosin. Mann-Whitney U-test was used for statistical analysis. A P-level less than 0.05 was considered significant. RESULTS In comparison with G1, there was a statistically significant reduction in the mean ovarian cyst dimensions in G2, while there were no significant differences between the two groups with respect to total number of follicles. Again, a significant increase in apoptotic activity and germinal epithelial degeneration was observed in G2 as compared to G1. The two groups were similar in terms of adhesion formation. CONCLUSION Although 95% EST results in a reduction in the size of simple ovarian cysts, this effect seems to be achieved at the expense of ovarian tissue injury.
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Affiliation(s)
- Mehmet Şimşek
- Department of Obstetrics and Gynecology, Firat University School of Medicine, Elazig, Turkey
| | - Tuncay Kuloğlu
- Department of Histology, Firat University School of Medicine, Elazig, Turkey
| | - Şehmus Pala
- Clinic of Obstetrics and Gynecology, Batman Yasam Hospital, Batman, Turkey
| | - Abdullah Boztosun
- Department of Obstetrics and Gynecology, Akdeniz University School of Medicine, Antalya, Turkey
| | - Behzat Can
- Department of Obstetrics and Gynecology, Firat University School of Medicine, Elazig, Turkey
| | - Remzi Atilgan
- Department of Obstetrics and Gynecology, Firat University School of Medicine, Elazig, Turkey
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Yonguc T, Sen V, Aydogdu O, Bozkurt IH, Yarimoglu S, Polat S. The comparison of percutaneous ethanol and polidocanol sclerotherapy in the management of simple renal cysts. Int Urol Nephrol 2015; 47:603-7. [DOI: 10.1007/s11255-015-0953-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Accepted: 03/08/2015] [Indexed: 10/23/2022]
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Castellarnau Visus M, Ponce Sebastia J, Carreras Collado R, Cayuela Font E, Garcia Tejedor A. Preliminary Results: Ethanol Sclerotherapy After Ultrasound-Guided Fine Needle Aspiration Without Anesthesia in the Management of Simple Ovarian Cysts. J Minim Invasive Gynecol 2015; 22:475-82. [DOI: 10.1016/j.jmig.2014.12.158] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2014] [Revised: 12/14/2014] [Accepted: 12/16/2014] [Indexed: 10/24/2022]
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Oh HC, Seo DW. Endoscopic ultrasonography-guided pancreatic cyst ablation (with video). JOURNAL OF HEPATO-BILIARY-PANCREATIC SCIENCES 2015; 22:16-19. [DOI: 10.1002/jhbp.179] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
Affiliation(s)
- Hyoung-Chul Oh
- Division of Gastroenterology; Chung-Ang University College of Medicine; Seoul Korea
| | - Dong Wan Seo
- Division of Gastroenterology; University of Ulsan College of Medicine; Asan Medical Center; 42 Olympic-ro Songpa-gu Seoul 138-736 Korea
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Oh HC, Seo DW, Kim SH, Min B, Kim J. Systemic effect of endoscopic ultrasonography-guided pancreatic cyst ablation with ethanol and paclitaxel. Dig Dis Sci 2014; 59:1573-7. [PMID: 24474574 DOI: 10.1007/s10620-014-3037-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2013] [Accepted: 01/09/2014] [Indexed: 12/13/2022]
Abstract
BACKGROUND Endoscopic ultrasonography (EUS)-guided pancreatic cyst ablation is a minimally invasive treatment modality. Local injection of ablative agents may rarely cause systemic effects in patients. AIMS This study aimed to evaluate the systemic effect of ablative agents by analyzing the plasma drug concentration. METHODS Ten patients with pancreatic cysts were enrolled. Cyst ablation was performed by 99 % ethanol lavage (2.5-70 mL) and paclitaxel (Genexol-polymeric micelle, 6.0-24.0) injection. Blood samples were collected at 0, 2, 4, 7 and 24 h. Plasma paclitaxel concentration was analyzed by a liquid chromatography-tandem mass spectrometry with the lowest limit of quantitation of 0.1 ng/mL. Procedure-related complications were closely monitored. RESULTS Pancreatic cysts were located at the head in two, body in seven and tail in one patient. Eight cysts were septated. Median diameter and original volume were 39.5 mm (range 2.7-21.8) and 14.79 mL (3.42-343.30). Median cyst fluid CEA and amylase values were 17.10 ng/mL (0.5-14127.5) and 73.50 U/L (3.1-91,590). Peak plasma paclitaxel concentration values were observed between 2 and 7 h, ranging from 0.45 to 14.73 ng/mL. The highest concentration (17.10 ng/mL at 0 h) was observed in a patient who had intracystic bleeding. Mild abdominal pain occurred in five patients and vomiting in one patient during the first 48-h monitoring. CONCLUSION Plasma paclitaxel concentration after EUS-guided pancreatic cyst ablation was nearly as low as the undetectable value and rarely caused systemic side-effect.
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Affiliation(s)
- Hyoung-Chul Oh
- Division of Gastroenterology, Chung-Ang University College of Medicine, Seoul, Korea
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In HS, Kim DW, Park YM, Kim B. Experimental intraperitoneal injection of alcohol in rats: Peritoneal findings and histopathology. Toxicol Rep 2014; 1:31-35. [PMID: 28962223 PMCID: PMC5598495 DOI: 10.1016/j.toxrep.2014.03.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2014] [Revised: 03/03/2014] [Accepted: 03/04/2014] [Indexed: 11/16/2022] Open
Abstract
PURPOSE This study aimed to evaluate the macroscopic and microscopic peritoneal findings after intraperitoneal injection of alcohol in rats. METHODS From January to February 2012, 20 male rats were used in this study: 15 rats received intraperitoneal injection of 0.1 mL 99.9% alcohol (group 1: experiment group) and 5 rats received intraperitoneal injection of 0.1 mL normal saline (group 2: control group). Animals from each group were sacrificed the day after alcohol injection and each week thereafter. Macroscopic and microscopic examinations of the peritonea and abdominal cavity were performed in each rat. RESULTS There was no significant peritoneal abnormality on macroscopic view, except for a whitish-colored parietal peritoneum around the injection site in 3 animals from group 1. In all but 1 of the animals in group 1, mild to moderate peritoneal inflammation or fibrosis was observed 1 and 2 weeks after alcohol injection. However, the peritoneal abnormality of alcohol injection had dissipated by week 3. Peritoneal abnormalities were not observed in group 2. CONCLUSION An intraperitoneal injection of alcohol in rats caused peritoneal inflammation or fibrosis during the first 2 weeks. However, these peritoneal abnormalities were short-lived and had completely disappeared after 3 weeks.
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Affiliation(s)
- Hyun Sin In
- Department of Radiology, Busan Paik Hospital, Inje University College of Medicine, Busan 614-734, South Korea
| | - Dong Wook Kim
- Department of Radiology, Busan Paik Hospital, Inje University College of Medicine, Busan 614-734, South Korea
| | - Young Mee Park
- Department of Radiology, Busan Paik Hospital, Inje University College of Medicine, Busan 614-734, South Korea
| | - Bomi Kim
- Department of Pathology, Busan Paik Hospital, Inje University College of Medicine, Busan 614-734, South Korea
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Atilgan R, Ozkan ZS, Kuloglu T, Kocaman N, Baspinar M, Can B, Şimşek M, Sapmaz E. Impact of intracystic ethanol instillation on ovarian cyst diameter and adjacent ovarian tissue. Eur J Obstet Gynecol Reprod Biol 2013; 174:133-6. [PMID: 24411950 DOI: 10.1016/j.ejogrb.2013.12.019] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2013] [Revised: 11/04/2013] [Accepted: 12/12/2013] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To investigate the regression level of simple ovarian cyst size after local ethanol application and the damage level of adjacent ovarian reserve in rats. STUDY DESIGN This study was conducted at Firat University Animal Laboratory with 18 mature (12-14 weeks old) female Wistar albino rats weighing 200-220g, with regular cycles. Ovarian cyst induction was performed with unilateral salpingectomy. Fourteen rats with ovarian cysts after a second laparotomy were divided into two groups as follows: Group 1 (n=7): cyst aspiration group, and Group 2 (n=7): intracystic 95% ethanol application group. One month after the cyst aspiration procedure a third laparotomy was performed. The cyst number and size were recorded for each rat. Right ovariectomy was performed and formalin-fixed/paraffin-embedded tissues were sectioned at 5μm thickness. Under light microscopy, ovarian total follicle reserve and fibrosis were evaluated with Masson trichrome staining and apoptosis was evaluated with TUNEL staining. The groups were compared with the Mann-Whitney U test and Wilcoxon Rank test. p<0.05 was considered significant. RESULTS Ovarian cyst formation was observed in 85% (15/18) of rats. The mean diameter of ovarian cysts in Groups 1 and 2 were, respectively, 10.3mm and 10.1mm. After aspiration, there was no significant reduction in the cyst diameter (10.3mm vs 8.1mm), but after ethanol application the diameter significantly reduced (10.1mm vs 3.4mm, p<0.05). Mean ovarian follicle count in Group 2 was significantly lower than in Group 1 (25 vs 42, p<0.05), and mean fibrosis and apoptosis scores in Group 2 were significantly higher than in Group 1 (2.5 vs 0.9, p<0.05). CONCLUSION Local ethanol application reduces cyst diameter but concomitantly decreases ovarian reserve due to increased fibrosis in rats. In humans, intracystic ethanol application should be performed cautiously.
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Affiliation(s)
- Remzi Atilgan
- Firat University School of Medicine, Department of Obstetrics and Gynecology, 23119 Elazig, Turkey
| | - Zehra Sema Ozkan
- Firat University School of Medicine, Department of Obstetrics and Gynecology, 23119 Elazig, Turkey.
| | - Tuncay Kuloglu
- Firat University School of Medicine, Department of Histology and Embryology, 23119 Elazig, Turkey
| | - Nevin Kocaman
- Firat University School of Medicine, Department of Histology and Embryology, 23119 Elazig, Turkey
| | - Melike Baspinar
- Firat University School of Medicine, Department of Obstetrics and Gynecology, 23119 Elazig, Turkey
| | - Behzat Can
- Firat University School of Medicine, Department of Obstetrics and Gynecology, 23119 Elazig, Turkey
| | - Mehmet Şimşek
- Firat University School of Medicine, Department of Obstetrics and Gynecology, 23119 Elazig, Turkey
| | - Ekrem Sapmaz
- Firat University School of Medicine, Department of Obstetrics and Gynecology, 23119 Elazig, Turkey
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Abstract
With modern cross-sectional imaging techniques, cystic lesions are very common and usually incidental findings, especially if small. However, when cysts enlarge, become infected, bleed, or undergo torsion, they can be symptomatic, and percutaneous drainage can be effective in the management. When cysts recur after aspiration, which is often the case for hepatic and renal cysts, cyst sclerosis or surgical unroofing may be required. This article describes the indications for and technical aspects of percutaneous sclerotherapy of cystic lesions of multiple organ systems.
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Affiliation(s)
- Danny Cheng
- University of California - Davis Medical Center, Sacramento, California
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EUS-guided pancreatic cyst ablation: a critical review (with video). Gastrointest Endosc 2013; 77:526-33. [PMID: 23321339 DOI: 10.1016/j.gie.2012.10.033] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2012] [Accepted: 10/29/2012] [Indexed: 02/07/2023]
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El-Shazly M, Allam A, Hathout B. Laparoscopic decortication of simple renal cyst with omental wadding technique: single-center experience. J Laparoendosc Adv Surg Tech A 2012; 22:886-8. [PMID: 23072411 DOI: 10.1089/lap.2011.0512] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE What is the impact of the omental wadding technique on decreasing the incidence of recurrence after laparoscopic decortication of the symptomatic simple renal cyst? This is the question we are trying to answer through this study. PATIENTS AND METHODS This is a cohort study of 14 consecutive patients who underwent transperitoneal laparoscopic decortication of a symptomatic simple renal cyst with the omental wadding technique between November 2007 and November 2011. The indication for surgery was for relief of pain in all cases. Pain was assessed preoperatively and at 1 month and every 6 months postoperatively using a pain numerical rating scale. Only simple cysts (Bosniak I and II) more than 10 cm in their greatest dimension were included in this study. Patients with complicated cysts (Bosniak III and IV) and those with cysts less than 10 cm in their greatest dimension were excluded from this study. Patients were 7 men and 7 women with a mean age of 47 years (range, 35-63 years), and the mean body mass index was 27 kg/m(2). Laparoscopic decortication was the primary treatment in 11 cases and the secondary treatment in 3 cases after sclerotherapy. We used the omental wadding technique to try to fill the cavity after decortication to decrease the incidence of recurrence with simple laparoscopic decortication reported in other series. We reviewed the preoperative and postoperative data. RESULTS The operation was successfully completed laparoscopically in all cases with a mean operative time of 97 minutes without major perioperative complications. Hospital stay was 2.4 days (range, 2-4 days). All cases improved significantly after operation in a mean follow-up of 1.5 years. Using this technique, we did not have any recurrence after surgery. CONCLUSIONS Laparoscopic decortication with omental wadding is helpful to decrease the incidence of simple renal cyst recurrence after laparoscopic decortication.
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Agarwal M, Agrawal MS, Mittal R, Sachan V. A Randomized Study of Aspiration and Sclerotherapy Versus Laparoscopic Deroofing in Management of Symptomatic Simple Renal Cysts. J Endourol 2012; 26:561-5. [DOI: 10.1089/end.2011.0559] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Mayank Agarwal
- Department of Surgery, SN Medical College, Agra, Uttar Pradesh, India
| | - Madhu S. Agrawal
- Department of Surgery, SN Medical College, Agra, Uttar Pradesh, India
| | - Ruchi Mittal
- Department of Surgery, SN Medical College, Agra, Uttar Pradesh, India
| | - Vivek Sachan
- Department of Surgery, SN Medical College, Agra, Uttar Pradesh, India
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Femoral nerve injury as a complication of percutaneous simple renal cyst sclerotherapy with ethanol: a case report. Case Rep Med 2012; 2012:589108. [PMID: 22489246 PMCID: PMC3318909 DOI: 10.1155/2012/589108] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2011] [Accepted: 01/19/2012] [Indexed: 11/17/2022] Open
Abstract
Simple renal cysts are benign, common, and often asymptomatic disease in old age, sometimes treated with ethanol sclerotherapy. We report a case of iatrogenic femoral nerve injury following percutaneous injection of ethanol into a renal cyst under sedation. The percutaneous injection was guided by sonography. At the end of the procedure, the cyst ruptured so the patient progressed to loss of consciousness due to alcohol intoxication. Ethanol was damaged to the femoral nerve, so patient was developed with limping, numbness, and weakness in anteromedial aspect of the right thigh. To the best of our knowledge, this is the first report of femoral nerve injury caused by percutaneous simple renal cyst sclerotherapy with ethanol. This rare event has not been previously described, Physicians should be aware of the possibility of this complication.
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Skolarikos A, Laguna MP, de la Rosette JJ. Conservative and radiological management of simple renal cysts: a comprehensive review. BJU Int 2012; 110:170-8. [DOI: 10.1111/j.1464-410x.2011.10847.x] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Abstract
Renal cysts are a common imaging finding. Although most cysts never have symptoms, some cause pain, collecting system compression, hematuria, hypertension, and secondary infection. The mere presence of a cyst is not an indication for intervention, but treatment may be indicated in symptomatic patients or those with secondary obstruction. Urinomas generally are a contained collection of urine outside of the normal pathways where urine travels. As such, urinomas can arise anywhere from the upper abdomen down into the low pelvis and have a variety of etiologies. Ureteral obstruction with forniceal rupture and trauma (blunt, penetrating, or iatrogenic) are the most common causes of urinomas. When urinomas arise spontaneously, the likely cause varies with the patient's age. Blunt or penetrating trauma can cause perinephric urinomas by two mechanisms-direct disruption of the pelvis or collecting system or by degeneration of nonviable tissue. These urinomas are often perinephric, but can also occur in a subcapsular location. This review will discuss diagnosis, classification, and treatment of renal cysts and urinomas.
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Affiliation(s)
- Jessica Lee
- Mallinckrodt Institute of Radiology, St. Louis, Missouri
| | - Michael Darcy
- Mallinckrodt Institute of Radiology, St. Louis, Missouri
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Wang LL, Dong XQ, Shao XH, Wang SM. Ultrasound-guided interventional therapy for recurrent ovarian chocolate cysts. ULTRASOUND IN MEDICINE & BIOLOGY 2011; 37:1596-1602. [PMID: 21856071 DOI: 10.1016/j.ultrasmedbio.2011.07.004] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2010] [Revised: 06/25/2011] [Accepted: 07/06/2011] [Indexed: 05/31/2023]
Abstract
The aim of this study was to determine the effectiveness of ultrasound-guided interventional therapy in the treatment of postoperative recurrent chocolate cysts. The 198 patients enrolled in this study were divided into three groups. In group 1, the saline washing group, the cavity of the cyst was washed thoroughly with warm saline. In group 2, the ethanol short-time retention group, after washing with saline, the cyst was injected with 95% ethanol with a volume of half of the fluid aspirated from the cyst. Ten minutes later, the rest of the ethanol was aspirated. In group 3, the ethanol retention group, the procedures were the same as with the ethanol short-time retention group, except that 95% of the ethanol was retained in the cyst. An ultrasound examination was performed in the third, sixth and 12th months after therapy. The chocolate cyst cure rate was significantly higher in the ethanol retention group (96%, 66/69) than in the ethanol short-time retention group (82%, 56/68) and no case was cured in the first group (saline washing). We conclude that ultrasound-guided injection and 95% ethanol retention are an effective therapy for the treatment of postoperative recurrent chocolate cysts.
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Affiliation(s)
- Lu-Lu Wang
- Department of Ultrasonography, The Fourth Hospital of Harbin Medical University, Harbin, P R China
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Vergès B, Buffier P, Baillot-Rudoni S, Brindisi MC, Bouillet B, Petit JM. Non-ultrasound-guided ethanol sclerotherapy for the treatment of thyroid cysts. ANNALES D'ENDOCRINOLOGIE 2011; 72:203-7. [DOI: 10.1016/j.ando.2011.04.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2010] [Revised: 04/18/2011] [Accepted: 04/18/2011] [Indexed: 11/28/2022]
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CT-Guided Sclerotherapy With Ethanol Concentration Monitoring for Treatment of Renal Cysts. AJR Am J Roentgenol 2011; 196:W78-82. [PMID: 21178037 DOI: 10.2214/ajr.10.4671] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Li EC, Hou JQ, Yang LB, Yuan HX, Hang LH, Alagirisamy KK, Li DP, Wang XP. Pure Natural Orifice Translumenal Endoscopic Surgery Management of Simple Renal Cysts: 2-Year Follow-Up Results. J Endourol 2011; 25:75-80. [PMID: 21247290 DOI: 10.1089/end.2009.0676] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- En-Chun Li
- Department of Urology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Jian-Quan Hou
- Department of Urology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Lin-Bin Yang
- Department of Urology, Jiaxing First Hospital, Jiaxing, Zhejiang, China
| | - He-Xing Yuan
- Department of Urology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Li-Hua Hang
- Department of Urology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | | | - Da-Peng Li
- Department of Urology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Xiao-Ping Wang
- Department of Urology, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China
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Oh HC, Seo DW, Song TJ, Moon SH, Park DH, Soo Lee S, Lee SK, Kim MH, Kim J. Endoscopic ultrasonography-guided ethanol lavage with paclitaxel injection treats patients with pancreatic cysts. Gastroenterology 2011; 140:172-9. [PMID: 20950614 DOI: 10.1053/j.gastro.2010.10.001] [Citation(s) in RCA: 155] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2010] [Revised: 09/03/2010] [Accepted: 10/08/2010] [Indexed: 02/06/2023]
Abstract
BACKGROUND & AIMS Endoscopic ultrasonography (EUS)-guided interventions have been used to treat patients with cystic lesions of the pancreas (CLPs). We used EUS to guide injection and lavage of ethanol, followed by injection of paclitaxel, into cysts, and investigated treatment response and predictors. METHODS Fifty-two patients were enrolled in the study using the following inclusion criteria: unilocular or oligolocular cysts, indeterminate cystic lesions that required EUS fine-needle aspiration, and cystic lesions that grew during the observation period. Forty-seven patients were followed up for more than 12 months and their outcomes were analyzed. RESULTS The mean diameter of the CLPs was 31.8 mm (range, 17-68 mm) and the estimated volume was 14.09 mL (range, 1.16-68.74 mL). Twenty CLPs were oligolocular. The mean level of carcinoembryonic antigen was 463 ng/mL (range, 1-8190 ng/mL). The median follow-up period was 21.7 months. A complete response was observed in 29 patients, a partial response in 6 patients, and persistent cysts in 12 patients. Four of 12 patients with persistent cysts underwent surgery. The histopathologic degree of epithelial ablation varied from 0% to 100%. Based on univariate analysis, EUS diameter and original volume predicted cyst resolution; in multivariate analysis, only original volume predicted resolution. Mild pancreatitis and splenic vein obliteration each occurred in 1 patient. CONCLUSIONS EUS-guided injection and lavage of ethanol, followed by injection of paclitaxel, appears to be a safe method for treating pancreatic cysts; 62% of patients had complete resolution. Small cyst volume predicted complete resolution.
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Affiliation(s)
- Hyoung-Chul Oh
- Division of Gastroenterology, Chung-Ang University College of Medicine, Seoul, Korea
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