ABSTRACT
BACKGROUND: When microwave ablation (MWA) is used for subpleural lesions, severe pain was the common side effect under the local anesthesia conditions during the procedure and postprocedure. To study the pain relief effect of artificial pneumothorax in the treatment of subpleural lung tumors with MWA. MATERIALS AND METHODS: From February 2012 to October 2014, 37 patients with 40 subpleural lung tumors underwent MWA, including 17 patients of 19 sessions given artificial pneumothorax prior to MWA (group‑I), and 20 patients of 21 sessions without artificial pneumothorax (group‑II). Patient’s pain assessment scores (10‑point visual analog scale [VAS]) at during‑procedure, 6, 12, 24, and 48 h after the MWA procedure and mean 24 h morphine dose were compared between the two groups. Complications of the artificial pneumothorax were also summarized. RESULTS: Pain VAS were 0.53, 0.65, 1.00, 0.24, and 0.18 at during‑procedure, 6, 12, 24, and 48 h for group‑I and 5.53, 2.32, 2.82, 1.21, and 0.21 for group‑II, respectively. Pain VAS in group I was significantly decreased at during‑procedure, 6, 12, and 24 h after the MWA (P < 0.001). No statistical pain VAS difference was observed at 48 h after the MWA between the two groups (P > 0.05). The mean 24 h morphine dose was 5.00 mg in group‑I and 12.63 mg in group‑II (P = 0.000). “Artificial pneumothorax” related complications occurred in two patients from group‑I, including one pleural effusion and one minor hemoptysis. No patient in group‑I and group‑II died during the procedure or in 30 days after MWA. CONCLUSION: Artificial pneumothorax is a safe and effective method for pain relief during MWA of subpleural lung tumors.
ABSTRACT
BACKGROUND: Patients suffering local recurrence of colorectal cancer which cannot be surgically removed are troubled with severe pain and poor quality of life. The aim of this study is to evaluate the efficacy and safety of computed tomography (CT)‑guided microwave ablation (MWA) as palliative treatment for recurrent unresectable colorectal cancer. MATERIALS AND METHODS: Thirty‑one patients were suffering locally recurrent colorectal cancer underwent MWA with CT guidance. The MWA power was set at 60–80 W, 6–8 min. Effectiveness was evaluated by visual analog scale (VAS) with a follow‑up of 6‑month. Complications were also recorded. RESULTS: Technical success was achieved in all patients. Mean VAS preprocedure was 7.10. Mean VAS postprocedure were as follows: 1 week, 2.65 (P < 0.001); 1 month, 0.81 (P < 0.001); 3 months 0.45 (P < 0.001); and 6 months 0.19 (P < 0.001). No serious complications were observed including intestinal fistulas, bladder fistulas, or peripheral vascular or nerve injury. CONCLUSIONS: CT‑guided MWA as treatment of recurrent colorectal cancer can quickly and effectively relieve pain. It is a minimally invasive, safe, and efficient palliative treatment of recurrent colorectal cancer.
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BACKGROUND: Bronchopleural fistula (BPF) complicating lung tumor ablation is rare but severe. The purpose of this article was to study its characteristics and treatments. MATERIALS AND METHODS: Two of 682 (0.3%) sessions of lung microwave ablation (MWA) were complicated with BPF and documented. Two electronic databases were searched for reported cases of BPF after lung tumor ablation. Case selection and data collection were done by 3 independent reviewers. RESULTS: A 56‑year‑old man and a 61‑year‑old woman developed BPF after MWA and died. Thirteen cases (mean age 63.8, 61.5% male) of BPF with adequate information were identified from 8 articles. Of the 13 cases, 5 (38.5%) had pulmonary co‑morbidity, 3 (23.1%) had a history of pulmonary surgery, 7 (53.8%) had a target tumor adjacent or abutting pulmonary pleura, and 6 (46.2%) developed severe infections. After chest tube placement, pleurodesis, endoscopic therapy, surgery, and other treatments, 12 were cured and 1 died of BPF and pneumonia. CONCLUSION: BPF is a rare but severe complication of lung ablation, and the management needs a multidisciplinary and individualized treatment strategy.
ABSTRACT
To evaluate scallop safety in the Guangzhou seafood market, contents of shellfish toxins in adductor muscle, mantle skirts, gills and visceral mass of scallops were examined using enzyme-linked immunosorbent assay (ELISA) and mouse unit assay. The results showed that: paralytic shellfish poisoning contents were up to 37.44 µg/100 g by ELISA and 319.99 MU/100 g by mouse unit assay, which did not exceed the limits of national standards (80 µg/100g and 400 MU/100 g); the contents of diarrhetic shellfish poisoning were 142.04 µg/100g and 0.2 MU/100 g, which exceeded the national standard limits (60 µg/100g); neurotoxic shellfish poisoning was undetectable; the contents of amnesic shellfish poisoning reached 220.12 µg/100g (no limit value could be referred to) . In addition, these poisons were present mainly in visceral mass and gills rather than adductor muscle and mantle skirts, suggesting that these toxins accumulate in a tissue-specific manner.(AU)