ABSTRACT
Objective To summarize clinical experience in removal of residual metallic foreign body in the soft tissue.Methods Clinical data of 742 cases with residual metallic foreign body in the soft tissue were analyzed.All the patients were forward from other hospitals with failed removal of the foreign body.Second surgery was performed in our hospital by grasping forceps using 3D-locator under the guidance of the C-shaped arm X-ray machine.Results Foreign body,such as scrap-iron,broken needle,nails,wine and so on located at different regions of soft tissues including neck,chest and abdomen,pelvis,and the four limbs were all successfully taken out.Removal rate of the foreign body was 100％.No complications such as bleeding,infection and nerve damage was occurred.The mean time of the procedures and radiation exposure for the removal surgery was 5 minutes.Conclusion Using 3D-locator and grasping forceps under the guidance of the X-ray,the residual metallic foreign bodies can be removed safely and efficiently.
ABSTRACT
ObjectiveTo evaluate the past 5 years' clinic experience of diagnosis and treatment of the pediatric soft-tissue foreign body (STFB),and to probe new strategies for its clinical management.MethodsTotally 165 consecutive children with small radiopaque STFB were involved.All the children were diagnosed with X-rays.CT (enhanced CT in 9 children)and virtual anatomy imaging (VAI) were performed in 40 children.Percutaneous foreign body forceps removal guided with C-arm video-fluoroscopy was performed and the effect was evaluated.ResultsThe longest dimension of STFB ranged from 1 mm to 40 mm,and the shortest dimension ranged from 1 mm to 5 mm,including scrap-iron,broken iron nails and needles,and glass pieces embedded in soft tissues under surface of the limbs,neck,chest,abdomen and pelvis.Seventy-six (76/165,46.06 ％) children received interventional therapy,and 73 were completely cured (73/76,96.05 ％),2 were partially cured (2/76,2.63 ％),and 1 was failed (1/76,1.32 ％).VAI accurately depicted STFB closely to large vessels even associated vascular complication with local large hematomas or pseudoaneurysms,helped to select the treatment methods and the forceps removal roads.Hematoma,infection,neural damages and other serious complications did not occur during and after operation.ConclusionVideo-fluoroscopy-guided percutaneous foreign body forceps removal is minimally invasive,safe and effective for small radiopaque STFBs,but may not suitable for the one very close to large blood vessels with or without vascular injuries complications.Preoperative CT VAI is helpful to locate STFB within complicated anatomic structures,selecting optimal intervention pathway and assessing the risk of intervention.
ABSTRACT
Objective To study the method and effect of the combination treatment based on the minimally invasive surgery and radioactive seeds brachytherapy for lung cancer. Methods Entered the study there were 12 cases of lung cancer (4 cases of primary lung cancer, 3 cases of recurrent lung cancer, and 5 cases of metastatic lung cancer) between November 2001 and February 2002. All the 12 patients received thoracoscopic mini operations, including 5 cases of local wedge-shaped tumor resection combined with seeds implantation, 3 cases of radio frequency thermaerotherapy combined with seeds implantation, 3 cases of percutaneous radio frequency with seeds implantation, and 1 case of seeds implantation only. Postoperative combination treatment was conducted in accordance with the patient's general condition. Results All the patients were followed for (12～30) months. The local control rate in the study was 83%, and the survival time was more than 1 year. Two patients expired in the 18th and 21st postoperative months, respectively. No decreases of the white blood cell and platelet took place. Conclusions The combination treatment based on minimally invasive surgery and radioactive seeds brachytherapy provides high local control rate, high life quality and satisfactory survival time.