ABSTRACT
Los neuromas de muñón son causa de dolor intenso de difícil control. El bloqueo neurolítico es una alternativa en el tratamiento, y el uso de la ultrasonografía se impone para garantizar la efectividad del proceder. En este reporte de caso se describe la realización de la neurolisis con alcohol absoluto de varios neuromas recidivantes en un muñón de miembro superior, guiados por ultrasonido, en un paciente con dolor crónico que no resuelve con tratamiento médico.
Stump-neuromas cause difficult deep pain control. Neurolytic block is an alternative treatment, and ultrasound guarantee the certainty of the procedure. This case report describes the realization of neurolysis with total alcohol of various stump-neuromas, guided by ultrasound, in a patient with chronic pain that don´t solve with medic treatment.
Subject(s)
Humans , Male , Aged , Ultrasonography/statistics & numerical data , Patient Satisfaction , Neuromuscular Blockade/adverse effects , Chronic Pain/therapy , Amputation Stumps , Neuroma/therapyABSTRACT
INTRODUCCIÓN. En más del 75 por ciento de los pacientes con cáncer de esófago, los procedimientos que se realizan son paliativos y existe un dilema ético sobre la forma de solucionar el problema fundamental: la alimentación. El objetivo de esta investigación fue señalar la importancia de las infiltraciones con alcohol absoluto para lograr la implantación de prótesis esofágicas artesanales por el método de tracción. MÉTODOS. Se realizó un estudio prospectivo y lineal con pacientes con cáncer de esófago irresecable, ingresados entre 1995 y 2009. Fueron evaluados 112 pacientes, de los cuales 65 fueron tratados con métodos paliativos. Se colocaron 55 prótesis esofágicas y en 10 de estos casos fue necesario canalizar previamente el tumor con infiltraciones de alcohol absoluto. RESULTADOS. Se consiguió pasar la sonda nasogástrica en el 90 por ciento de los pacientes que necesitaron infiltraciones de alcohol absoluto. Fueron necesarias entre 1 y 2 sesiones, pero uno de los pacientes necesitó 3 sesiones de infiltración. No hubo complicaciones. CONCLUSIONES. La combinación de alcohol absoluto y prótesis permite eliminar la disfagia en el cáncer avanzado de esófago y cardias. Cuando existe estenosis total, el alcohol absoluto es un método adecuado para canalizar la estenosis tumoral de esófago antes de colocar la prótesis. En la mayoría de los casos son suficientes 1 o 2 sesiones de infiltración(AU)
INTRODUCTION. In more than 75 percent of patients presenting with esophageal cancer the procedures performed are of type palliative and there is a ethical dilemma on the way to solve the major problem: the feeding. The objective of present paper was to emphasize the significance of infiltrations with absolute alcohol to achieve the implantation of handmade esophageal prostheses using the traction method. METHODS. A linear and prospective study was performed in patients presenting with non-resectable esophageal cancer admitted between 1995 and 2009. A total of 112 patients were assessed with 65 of them treated using palliative methods. Fifty five esophageal prostheses were placed and in 10 of these cases it was necessary to tunnelled previously the tumor with absolute alcohol infiltrations. RESULTS.The nasogastric tube was passed in the 90 percent of patients needing infiltrations of absolute alcohol. One or two sessions were necessary but one of them need three sessions of infiltrations without complications. CONCLUSIONS.The combination of absolute alcohol and prosthesis allows to eliminate the dysphagia in cases of advanced cancer and cardias. When there is a total stenosis, the absolute alcohol is a appropriate method to canalize the esophageal tumoral stenosis before to place the prosthesis. In most of cases are enough 1 or 2 sessions of infiltrations(AU)
Subject(s)
Humans , Alcohols/therapeutic use , Prosthesis Implantation/methods , Infiltration-Percolation/methods , Esophageal Neoplasms/rehabilitation , Esophageal Neoplasms/therapy , Prospective Studies , Linear ModelsABSTRACT
Objective To evaluate the effects of color Doppler ultrasound guided percutaneous aspiration and absolute alcohol sclerotherapy on abdominal viscera cysts.Methods38 abdominal cysts in 33 cases were treated under Color Doppler ultrasound guided percutaneous aspiration and sclerotherapy with injection of absolute alcohol.Results After absolute alcohol treatment for 38 cysts in 33 cases,the cure rate was 89%,the efficacy rate was 100%.Con- clusion Color Doppler ultrasound Guided puncture sclerosing therapy of abdominal viscera cyst is a simple,safe and effective method.
ABSTRACT
Tipo de estudio y objetivos: En el hospital del Niño Dr. Francisco de Ycaza Bustamante se realizó un ensayo clínico controlado y aleatorio entre el 1 de enero del 2003 al 31 de enero del 2004 con el fin de demostrar que la aplicación del alcohol absoluto intralesional, detiene el crecimiento de hemangiomas capilares.Población: Se escogieron 83 pacientes pediátricos menores de 10 años, en quienes se aplicó dos dosis de 0,5 a 2 mL de alcohol absoluto al 100% intralesional + 1ml de lidocaína. Se incluyeron pacientes sin tratamiento previo, sin enfermedades concurrentes, con posibilidad de control posterior al tratamiento.Medidas: El análisis estadístico para la comparación intergrupo empleó la prueba Z, mediante el programa estadístico STATS.Resultados: Existió mayor regresión de la lesión con aplicación de alcohol absoluto que con cirugía (p<0.001). La administración de corticoides, la embolización selectiva y el vendaje; no lograron la remisión del cuadro hasta la finalización del seguimiento. La presencia de complicaciones también fue mayor en el grupo sometido a tratamiento convencional (p<0.001).Conclusiones: El uso de alcohol absoluto en pacientes pediátricos es una excelente opción de tratamiento temporal, inclusive puede considerarse tratamiento definitivo en ciertos casos o coadyuvante al tratamiento quirúrgico.
Type of study and objectives: A controlled and alleatory clinical study was conducted at the Infantile Dr. Francisco de Ycaza Bustamante Hospital during the period January 1st of 2003-January 31 of 2004 with the objective of demonstrating that the use of intralesional absolute alcohol, stops the growth of capillary hemangiomas.Population: 83 pediatric patients under 10 years of age were selected, in which 2 doses of 0,5 to 2ml of intralesional absolute alcohol at 100% + 1ml of lidocayne. Patients with prior treatment, concurrent diseases or with possible control post treatment were excluded.Materials: The statistical analysis for the inter group comparison used the Z test under the statistical stats program.Results: There was greater regression of the lesion with the application of absolute alcohol rather than surgical (p<0.001). The use of corticoids, selective embolization and bandaging; did not accomplish remission of the course until the ending of following. The presence of complications was also greater in the group under conventional treatment (p<0.001).Conclusions: The use of absolute alcohol in pediatric patients is an excellent temporal option of treatment, it can even be considered as a definite treatment in certain cases or as a coadyuvant to surgical treatment.
Subject(s)
Male , Female , Child, Preschool , Child , Congenital Abnormalities , Hemangioma, Capillary , Therapeutics , Ethanol , Surgical Procedures, OperativeABSTRACT
Generally, absolute alcohol embolization has been commonly used for treatment of arteriovenous malformation (AVM) because complete surgical extirpation of AVM can be an extremely hazardous and difficult. Even if absolute alcohol is safe embolic agent, it can result in pain, pulmonary hypertension, pulmonary embolism and post-embolization syndrome such as nausea, vomiting, hemolysis and myoglobinuria. So, general anesthesia is needed for alcohol embolization. In this case, anesthesia was induced with intravenous (IV) propofol 110 mg and succinylcholine 60 mg and maintained with propofol and vecuronium. The pulmonary artery pressure was monitored with a Swan-Ganz catheter. After alcohol injectons, systolic pulmonary artery pressure was increased, ranging 35-40 mmHg. And cola-colored urine was noticed. For treatment of pulmonary hypertension, nitroglycerine was given IV. The IV fluid rate was increased and furocemide was given IV to increase the urine output. After general anesthesia, the patient was awake but appeared to be alcohol-intoxicated. Blood alcohol level was 42 mg/dl. Urinalysis showed large amounts of myoglobin, hemoglobin and albumin. So, anesthesiologists have to keep in mind of such complications when absolute alcohol embolization is done.
Subject(s)
Humans , Anesthesia , Anesthesia, General , Arteriovenous Malformations , Catheters , Ethanol , Hemolysis , Hypertension, Pulmonary , Myoglobin , Myoglobinuria , Nausea , Nitroglycerin , Propofol , Pulmonary Artery , Pulmonary Embolism , Succinylcholine , Urinalysis , Vecuronium Bromide , VomitingABSTRACT
PURPOSE: In patients suffering from prostate cancer, endocrine treatment is commonly applied to either locally advanced or metastatic prostate cancer. But, there are many side effects with endocrine treatment in spite of its good response. We studied the effect of castration using absolute alcohol injection into the testis of Sprague-Dawley rats. MATERIALS AND METHODS: We checked and compared the serum testosterone level after surgical castration and the injection of a serial amount of alsolute alcohol into the testis of sixty Sprague-Dawley rats. The histologic findings of the testes and prostates in those injected with absolute alcohol were also evaluated. RESULTS: The testosterone level of normal control was 2.29 +/-0.47ng/ microliterand that of the bilateral orchiectomy group was 0.03 +/-0.02ng/ml. The testosterone level of the groups that were injected with absolute alcohol more than 25% of testicular weight were the same as the testosterone level of castrated rats. The histologic findings of the testes and prostates in those injected with absolute alcohol more than 25% of testicular weight were diffusely atrophied. CONCLUSIONS: We suggest that chemical orchiectomy using absolute alcohol as a new endocrine treatment is another modality in advanced prostatic cancer patients who need an orchiectomy.
Subject(s)
Animals , Humans , Rats , Castration , Ethanol , Orchiectomy , Prostate , Prostatic Neoplasms , Rats, Sprague-Dawley , Testis , TestosteroneABSTRACT
Objective To evaluate the clinical value of bronchial artery infusion(BAI)combined with percutaneous intratumor alcohol injection(PAI)in the treatment of advanced lung cancer.Methods Thirty-two lesions confirmed by pathology,including 13 cases of primary bronchogenic carcinoma and 5 cases of pulmonary multi-metastasis tumor from hepatocellular carcinoma,were treated by 52 times of BAI and 78 times of PAI guided by fluoroscopy or CT .One cases of lung tumor was operated after the interventional therapy,and the specimen was studied with pathologic histology.Results The pathologic finding showed there was a large area necrosis in the tumor.The total effective rate of treatment was 83.8%.The 6,12 and 18 months suivival rates were 100%,77.7% and 61% respectively.Conclusion The combined interventional therapy of BAI and PAI is a more effective synthetical method for treatment only for primary tumor,but also metastasis lesions.It have better cooperative effect on the bigger lesions of lung carcinoma.