Complications and seeding risk after percutaneous liver biopsy in an oncological setting.

2018 ◽  
Vol 36 (4_suppl) ◽  
pp. 246-246 ◽  
Author(s):  
Katja De Paepe ◽  
Lawrence Bonne ◽  
Nicos Fotiadis ◽  
Naureen Starling ◽  
Ian Chau ◽  
...  
Keyword(s):  
Liver Biopsy ◽  
Percutaneous Biopsy ◽  
Minimal Risk ◽  
Percutaneous Liver Biopsy ◽  
Ct Guided ◽  
Non Invasive ◽  
Needle Tract ◽  
Invasive Method ◽  
Tumor Types

246 Background: Percutaneous biopsy of suspected liver metastases is a common practice for diagnostic purposes. Particularly, in the setting of oncological clinical trials, it is a relatively non-invasive method to obtain sufficient tissue for molecular analyses at regular set time points. However, various complications may occur, including seeding of the tumour along the biopsy tract. Only few reports exist on the actual incidence of seeding, on a limited number of tumor types. The aim of this study was to evaluate the technique’s safety and risk of seeding. Methods: All patients with an ultrasound or CT-guided liver biopsy between 2012-2016 were included. Medical records were reviewed retrospectively for post-biopsy complications and all follow-up imaging was re-assessed for the presence of seeding, defined as tumoral deposits in the biopsy needle tract. Results: In total 782 biopsies were performed in 550 patients (282 women, 268 men; mean age of 61 years), 43.9% (343/782) for trials and 56.1% (439/782) for diagnostic/molecular purposes, 93.7% (733/782) were diagnostic, revealing malignancy in 96.9% (710/733). Number of biopsies per patient ranged between 1 (n=387) to 7 (n=1), a co-axial system was used in 70.6% (552/782) and multiple passes in 29.4% (230/782). Complications were reported in 8.8% (69/782), more often pain (4.7%) and hypotension/vasovagal (2.3%). Admission and/or re-intervention were needed for more severe complications as bleeding (1.0%), sepsis/fever (1.1%), pulmonary embolism (0.3%) and pneumothorax (0.4%). Seeding was seen in 1.1% (8/782) of cases (2/44 melanoma, 1/11 GIST, 1/39 cholangiocarcinoma, 1/247 colorectal, 1/14 oesophagus, 1/97 breast, 1/31 prostate). Mean time for seeding was 208 days (range 43-469 d); mean post-biopsy survival time was 495 days in the seeding and 349 days in the non-seeding group. Conclusions: Percutaneous liver biopsy is a highly effective and safe method for tissue collection, with only a minimal risk of seeding.

scholarly journals Clinical Application of CT-Guided Percutaneous Microwave Ablation for the Treatment of Lung Metastasis from Colorectal Cancer

2017 ◽  
Vol 2017 ◽  
pp. 1-9
Author(s):  
Lin Li ◽  
Ketong Wu ◽  
Haiyang Lai ◽  
Bo Zhang
Keyword(s):  
Colorectal Cancer ◽  
Lung Metastasis ◽  
Microwave Ablation ◽  
Progression Free Survival ◽  
Ct Guided ◽  
Metastatic Lesions ◽  
Local Progression ◽  
Invasive Method ◽  
Percutaneous Microwave Ablation

Objective. The aim of our research is to explore the clinical efficacy and safety of CT-guided percutaneous microwave ablation (MWA) for the treatment of lung metastasis from colorectal cancer. Materials and Methods. CT-guided percutaneous MWA was performed in 22 patients (male 14, female 8, mean age: 56.05 ± 12.32 years) with a total of 36 lung metastatic lesions from colorectal cancer between February 2014 and May 2017. Clinical data were retrospectively analyzed with respect to the efficacy, safety, and outcome. Results. Of the 36 lesions, 34 lesions (94.4%) reduced obviously with small cavitations or fibrous stripes formed and had no evidence of recurrence during follow-up. The volume of the other 2 lesions demonstrated local progression after 6 months by follow-up CT. The primary complications included pneumothorax (28%), chest pain (21%), and fever (5%). These symptoms and signs were obviously relieved or disappeared after several-day conservative treatment. The mean follow-up of the patients was 25.54 ± 12.58 months (range 2–41 months). The estimated progression-free survival rate was 94.4%. Conclusion. Our results demonstrate that CT-guided percutaneous MWA appears to be an effective, reliable, and minimally invasive method for the treatment of lung metastasis from colorectal cancer. This trial is registered with ChiCTR-ORC-17012904.

scholarly journals Endoscopic ampullectomy

2012 ◽  
Vol 03 (S 05) ◽  
pp. 065-067 ◽  
Author(s):  
Michael Bourke
Keyword(s):  
Treatment Decision ◽  
Ampulla Of Vater ◽  
En Bloc ◽  
Non Invasive ◽  
Relative Safety ◽  
Invasive Method ◽  
En Bloc Excision ◽  
Bloc Excision ◽  
Careful Assessment

AbstractEndoscopic ampullectomy offers a minimally invasive method of effectively treating non-invasive neoplasms of the ampulla of Vater and surrounding peri-ampullary region with high success and relative safety. These lesions would otherwise require surgical intervention, including pancreatico-duodenectomy. However, major complications may occur and a careful assessment of the patients comorbidities and their ability to tolerate adverse events needs to be factored into the treatment decision. Careful staging, often multi-modality is required, particularly for extensive lesions. Complete en-bloc excision of the entire neoplasm should be the goal with conventional papillary adenomas. Large lesions with extra-papillary extension currently require extended piecemeal excision, however with meticulous technique, recurrence is uncommon in longterm follow up.

scholarly journals Liver Fibrosis: Causes and Methods of Assessment, A Review

2015 ◽  
Vol 53 (4) ◽  
pp. 304-314 ◽  
Author(s):  
Ali Erfani Karimzadeh Toosi
Keyword(s):  
Liver Fibrosis ◽  
Liver Biopsy ◽  
Hepatic Dysfunction ◽  
Current Knowledge ◽  
Treatment Strategies ◽  
Future Research ◽  
Progressive Development ◽  
Non Invasive ◽  
The Past ◽  
Invasive Method

AbstractHepatic fibrogenesis is the final result of injury to the liver. Fibrosis could lead to hepatic dysfunction, important in the pathogenesis of other chronic problems. Therefore, understanding the mechanism, accurate diagnosis and staging of it in early stages accelerates the treatment and reduces the prevalence of chirrosis. Treatment strategies of liver problems and detction methods depend on the amount and progression of liver fibrosis and the rate of cirrhosis development. Traditionally the invasive method, liver biopsy, is reference standard to follow progression and stage of fibrosis. However, during the past decade, progressive development of novel non-invasive methodologies has challenged the invasive method. Non-invasive methods have been initially introduced for chronic hepatitis C with increasing use in other chronic liver diseases. The need for liver biopsy has nowadays decreased significantly as a result of these methodologies. Most of the new non-invasive methods depend on either ‘biological’ or ‘physical’ approaches.In this review, starting from the mechanism of fibrogenesis, the current knowledge about diagnosis, treatment strategies and different methods for its evaluation is discussed. This is followed by a conclusion on what is expected to be known in this field during the future research.

Stereotactic Radiosurgery of Cranial Nonvestibular Schwannomas: Results of Single- and Multisession Radiosurgery

Neurosurgery ◽  
2011 ◽  
Vol 68 (5) ◽  
pp. 1200-1208 ◽  
Author(s):  
Clara Y. H. Choi ◽  
Scott G. Soltys ◽  
Iris C. Gibbs ◽  
Griffith R. Harsh ◽  
Gordon T. Sakamoto ◽  
...  
Keyword(s):  
Stereotactic Radiosurgery ◽  
Cranial Nerve ◽  
Medical Center ◽  
Cranial Nerves ◽  
Jugular Foramen ◽  
Tumor Control ◽  
Minimal Risk ◽  
Invasive Treatment ◽  
Non Invasive

Abstract BACKGROUND: Surgical resection of nonvestibular cranial schwannomas carries a considerable risk of postoperative complications. Stereotactic radiosurgery (SRS) offers a non-invasive treatment alternative. The efficacy and safety of multi-session SRS of nonvestibular cranial schwannomas has not been well studied. OBJECTIVE: To analyze the results of single- and multi-session SRS of nonvestibular cranial schwannomas. METHODS: From 2001 to 2007, 42 lesions in 40 patients were treated with SRS at Stanford University Medical Center, targeting schwannomas of cranial nerves IV (n = 1), V (n = 18), VII (n = 6), X (n = 5), XII (n = 2), jugular foramen (n = 8), and cavernous sinus (n = 2). SRS was delivered to a median marginal dose of 18 Gy (range, 15-33 Gy) in 1 to 3 sessions, targeting a median tumor volume of 3.2 cm3 (range, 0.1-23.7 cm3). The median doses for treatments in 1 (n = 18), 2 (n = 9), and 3 (n = 15) sessions were 17.5, 20, and 18 Gy, respectively. RESULTS: With a median follow-up of 29 months (range, 6-84 months), tumor control was achieved in 41 of the 42 lesions. Eighteen of 42 lesions (43%) decreased in size; 23 tumors (55%) remained stable. There were 2 cases of new or worsening cranial nerve deficits in patients treated in single session; no patient treated with multi-session SRS experienced any cranial nerve toxicity (P = 0.18). CONCLUSION: SRS of nonvestibular cranial schwannomas provides excellent tumor control with minimal risk of complications. There was a trend towards decreased complications with multi-session SRS.

scholarly journals Thermal Signature Based Sleep Analysis Sensor

2017 ◽  
Author(s):  
Ali Seba ◽  
Dan Istrate ◽  
Toufik Guettari ◽  
Adrien Ugon ◽  
Andrea Pinna ◽  
...  
Keyword(s):  
Muscle Tone ◽  
Physiological State ◽  
Complete Analysis ◽  
Sleep Stages ◽  
Non Invasive ◽  
Ocular Movements ◽  
Sleep Analysis ◽  
Invasive Method ◽  
Thermal Signature

This paper address the development of a new technic in the sleep analysis domain. Sleep is defined as a periodic physiological state during which vigilance is suspended and reactivity to external stimulations diminished. We sleep on average between six and nine hours per night and our sleep is composed of four to six cycles of about 90-minutes each. Each of these cycles is composed of a succession of several stages of sleep, more or less deep. The analysis of sleep is usually done using a polysomnography. This examination consists of recording, among other things, electrical cerebral activity by electroencephalography (EEG), ocular movements by electrooculography (EOG) and chin muscle tone by electromyography (EMG). The recording is done mostly in a hospital, more specifically in a service for monitoring the pathologies related to sleep. The readings are then interpreted manually by an expert to generate a hypnogram, a curve showing the succession of sleep stages during the night in 30-second epochs. The proposed method is based on the follow-up of the thermal signature that makes it possible to classify the activity into three classes: "awakening", "calm sleep" and "agitated sleep". The contribution of this non-invasive method is part of the screening of sleep disorders, to be validated by a more complete analysis of the sleep. The measure provided by this new system, based on temperature monitoring (patient and ambient), aims to be integrated into the tele-medicine platform developed within the framework of the Smart-EEG project by the SYEL - SYstèmes ELectroniques team. Analysis of the data collected during the first surveys carried out with this method showed a correlation between thermal signature and activity during sleep. The advantage of this method lies in its simplicity and the possibility of carrying out measurements of activity during sleep and without direct contact with the patient at home or hospitals.

scholarly journals Effects of the cryolipolysis using the advanced redux method in the treatment of localized adiposity

2020 ◽  
pp. 1-8
Author(s):  
Roseane Débora Barbosa Soares ◽  
Rodrigo Marcel Valentim da Silva ◽  
Júlio Costa e Silva ◽  
Bruna Figueiredo Pinto ◽  
Stephan Queiroga Farias ◽  
...  
Keyword(s):  
Adipose Tissue ◽  
Lymphatic Drainage ◽  
Controlled Clinical Trial ◽  
Suction Pressure ◽  
Application Time ◽  
Non Invasive ◽  
Abdominal Region ◽  
Invasive Method ◽  
Localized Adiposity

Background: Among the techniques used in clinical practice to reduce localized adiposity, cryolipolysis has been highlighted, which is a non-invasive method capable of reducing the thickness of the adipose tissue without damage to the surrounding tissues. However, several associations of techniques suggest an intensification of the results, associating cryolipolysis with other treatments, and the most common is ultracavitation (UCV) or radiofrequency (RF) and massage. Objective: To investigate the effects of cryolipolysis associated with UCV and RF on localized adiposity. Methods: This is a blinded and controlled clinical trial. The sample was composed of 30 females divided into 2 groups of 15: one group received cryolipolysis application in the abdominal region, and performed 1 session of drainage weekly; while another group performed the cryolipolysis and then 8 applications of UCV associated with RF and modeling massage (protocol named Advanced Redux Method – ARM), once a week. The parameters used in cryolipolysis were: temperature: -7ºC; suction pressure: 30 kpa; and application time: 50 min. For the UCV, the parameters were time of 8 minutes, 30w of potency and intensity of 10 w/cm2 . After cryolipolysis, a follow-up of 2 months was performed to verify the changes related to weight, perimeter and thickness of the adipose tissue, measured by ultrasonography. The reassessments were performed 30 and 60 days after the cryolipolysis. Results: It was observed that the ARM promoted a greater reduction of adiposity located in the abdominal region, in the plicometry, perimetry and ultrasonography variables (p<0.05). In the analysis of the questionnaires the ARM group showed lower edema, pain, ecchymosis after application when compared to the group associated only with the drainage. The percentage of satisfaction was also higher in the ARM group. Conclusion: Therefore, it can be observed that the association of UCV, RF and modeling massage through the ARM promoted a higher reduction in adiposity than the group that exclusively performed the cryolipolysis treatment with lymphatic drainage.

scholarly journals The Diagnostic Role of Urinary N-Acetyl-β-D-glucosaminidase (NAG) Activity in the Detection of Renal Tubular Impairment

2005 ◽  
Vol 48 (2) ◽  
pp. 75-80 ◽  
Author(s):  
Sylva Skálová
Keyword(s):  
Renal Damage ◽  
Perinatal Asphyxia ◽  
Non Invasive ◽  
Diagnostic Role ◽  
Invasive Method ◽  
Nephrotoxic Drugs ◽  
Renal Tubular

The kidney function can be assessed by a number of methods. The urinary excretion of enzymes, in particular N-acetyl-β-D-glucosaminidase (NAG), is considered a relatively simple, cheap, fast and non-invasive method in the detection and follow-up of renal tubular function under various conditions. The determination of urinary NAG provides a very sensitive and reliable indicator of renal damage, such as injury or dysfunction due to diabetes mellitus, nephrotic syndrome, inflammation, vesicoureteral reflux, urinary tract infection, hypercalciuria, urolithiasis, nephrocalcinosis, perinatal asphyxia, hypoxia, hypertension, heavy metals poisoning, treatment with aminoglycosides, valproate, or other nephrotoxic drugs. This paper gives an overview of the current use of urinary NAG in the detection of renal injury.

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