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Objective:To observe the clinical effect of the cannula under laparoscopy, percutaneous puncture cannula, and conventional surgery cannula for peritoneal dialysis.Methods:From May 3, 2015 to February 14, 2020, 87 patients with end-stage renal disease needing peritoneal dialysis in Ningbo Zhenhai People's Hospital were enrolled. These patients were divided into three groups including cannula under laparoscopy (23 cases), percutaneous puncture cannula (29 cases), and conventional surgery cannula (35 cases). The baseline characteristics, perioperative conditions (surgical time, post-surgical hospitalization time), the incidence of recent complications (abdominal hemorrhage, direct abdominal hemorrhage, incision pain, leakage, catheter shift, peritonitis), and long-term complications (catheter shift, peritonitis, hernia, thoracic and abdominal fistula, abdominal tube obstruction) among the three groups were compared.Results:Compared with the group of conventional surgery cannula, the operation time in the group of cannula under laparoscopy and the group of percutaneous puncture cannula were significantly shorter (minutes: 32.5±12.3, 28.9±11.8 vs. 61.3±15.4, both P < 0.05), the in-hospital stay in the group of cannula under laparoscopy and the group of percutaneous puncture cannula were reduced (days: 9.8±3.4, 9.2±2.6 vs. 10.7±3.2), but there was no statistical significance among the three groups ( P > 0.05). The incidence of abdominal bleeding, rectus abdominis bleeding, and incision pain in the group of cannula under laparoscopy and the group of percutaneous puncture cannula were significantly lower than those in the group of conventional surgery cannula [incidence of abdominal bleeding: 4.3% (1/23), 3.4% (1/29) vs. 22.9% (8/35), incidence of rectus abdominis bleeding: 4.3% (1/23), 3.4% (1/29) vs. 22.9% (8/35), incidence of incision pain: 8.7% (2/23), 10.3% (3/29) vs. 42.9% (15/35), all P < 0.01]. The difference between the group of cannula under laparoscopy and the group of percutaneous puncture cannula had no statistical significance. Compared with the group of conventional surgery cannula and the group of percutaneous puncture cannula, the incidence of catheter displacement in the group of cannula under laparoscopy was significantly reduced [4.3% (1/23) vs. 27.6% (8/29), 31.4% (11/35), both P < 0.05]. Compared with the group of conventional surgery cannula and the group of percutaneous puncture cannula, the incidence of catheter displacement in long-term complications in the group of cannula under laparoscopy was significantly reduced [4.3% (1/23) vs. 24.1% (7/29), 31.4% (11/35), both P < 0.05], however, the difference of that between the group of conventional surgery cannula and the group of percutaneous puncture cannula was not statistically significant. The incidence of hernia in the group of cannula under laparoscopy was significantly higher than that in the group of percutaneous puncture cannula or in the group of conventional surgery cannula [21.7% (5/23) vs. 3.4% (1/29), 2.8% (1/35), both P < 0.05], and all of that were umbilical hernia, however, the difference of that between the group of percutaneous puncture cannula and the group of conventional surgery cannula was not statistically significant. Conclusion:Compared with the traditional conventional surgical cannula placement methods, percutaneous puncture has the advantages of simple operation, short operation time, small trauma, but still cannot reduce the incidence of drift tube; laparoscopic peritoneal dialysis tube has the advantages of short operation time, small trauma and low catheter displacement rate, but increases the risk of umbilical hernia.
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OBJECTIVE@#To investigate the feasibility of a drill template for the placement of guided template of middle and upper thoracic percutaneous vertebroplasty in thoracic pedicle approach on digital design and 3D printing technology.@*METHODS@#The preoperative CT images of 20 patients with thoracic fracture were collected retrospectively. With the 3D soft tissue printing technology, the data was reconstructed by 3D imaging reconstruction software to produce 1∶1 three dimensional soft tissue model. The pedicle screw channel and the digital template were designed by the 3-matic module of Mimics15.0 software. After guide template was printed by 3D printer and three dimensional template was fixed on the model, 2.0 mm Kirschner was placed and the accuracy of a drill template was observed by CT scans, bone cement was injected through the puncture tube and verified with images. The time of nail guide design, guide template production and cost were recorded.@*RESULTS@#The effectiveness of three dimensional thoracic model and digital guided template of middle and upper thoracic percutaneous vertebroplasty of thoracic fractures in thoracic pedicle approach was confirmed. Kirschner was placed and the accuracy of screw placement was confirmed with CT scanning. Template and the corresponding anatomical landmark fitted well, bone cement had showed good filling. The average printing time of upper thoracic spine model with soft tissue, the mean time of nail guide design, guide template production and cost were (719.00±3.03) min, (12.30±1.01) min, (55.50±10.30) min and RMB 3 150 yuan on average respectively.@*CONCLUSION@#By means of individual design and 3D soft tissue printingtechnology, accurate placement of guided template of middle and upper thoracic percutaneous vertebroplasty could be realized.
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Humans , Pedicle Screws , Printing, Three-Dimensional , Retrospective Studies , Surgery, Computer-Assisted , VertebroplastyABSTRACT
Objective@#To explore the effect of 3D-slicer assisted soft channel drainage on the surgical outcome and prognosis of patients with hypertensive cerebral hemorrhage (HICH).@*Methods@#Seventy-six HICH patients treated in Zhejiang Xin'an International Hospital from January 2016 to December 2018 were randomly divided into the control group and the observation group, with 38 cases in each group. Both groups of patients underwent percutaneous cone cranial soft channel drainage.The control group patients used CT hematoma localization, and the observation group patients used 3D-slicer software hematoma localization. The perioperative related data, surgical results, complications and prognosis of patients in the two groups were observed and compared.@*Results@#The operation time and hospitalization time of patients in observation group were (76.24 ± 11.24) min and (15.21 ± 4.01) d, significantly shorter than those in control group [(103.17 ± 17.43) min and (18.63 ± 4.75) d], and there were significant differences (P < 0.05). The blood loss during operation and hematoma residual amount 7 d after operation in observation group were (77.21 ± 11.35) ml and (4.24 ± 0.87) ml, significantly lower than those in control group [(115.35 ± 21.22) ml and (18.63 ± 4.75) ml], and there were significant differences (P < 0.05). The hematoma clearance of patients 1 d and 3 d after operation in observation group were (83.24 ± 11.21) ml and (92.24 ± 15.63) ml, significantly higher than those in control group [(69.67 ± 10.73) ml and (85.57 ± 13.11) ml], and there were significant differences (P < 0.05). The incidence rates of intracranial rebleeding, intracranial infection and pulmonary infection in observation group were significantly lower than those in control group [2.63%(1/38) vs. 21.05%(8/38), 0 vs. 15.79% (6/38), 2.63%(1/38) vs. 21.05%(8/38)](P < 0.05). After treatment for 3 months, the good prognosis rate in observation group was significantly higher than that in control group [86.84%(33/38) vs. 65.79% (25/38)] (P < 0.05).@*Conclusions@#3D-slicer software based on percutaneous soft-channel puncture and drainage for HICH patients can achieve better surgical results, reduce the incidence of complications and improve the prognosis of patients.
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Objective To explore the effect of 3D-slicer assisted soft channel drainage on the surgical outcome and prognosis of patients with hypertensive cerebral hemorrhage (HICH). Methods Seventy-six HICH patients treated in Zhejiang Xin 'an International Hospital from January 2016 to December 2018 were randomly divided into the control group and the observation group, with 38 cases in each group. Both groups of patients underwent percutaneous cone cranial soft channel drainage.The control group patients used CT hematoma localization, and the observation group patients used 3D-slicer software hematoma localization. The perioperative related data, surgical results, complications and prognosis of patients in the two groups were observed and compared. Results The operation time and hospitalization time of patients in observation group were (76.24 ± 11.24) min and (15.21 ± 4.01) d, significantly shorter than those in control group [(103.17 ± 17.43) min and (18.63 ± 4.75) d], and there were significant differences (P < 0.05). The blood loss during operation and hematoma residual amount 7 d after operation in observation group were (77.21 ± 11.35) ml and (4.24 ± 0.87) ml, significantly lower than those in control group [(115.35 ± 21.22) ml and (18.63 ± 4.75) ml], and there were significant differences (P < 0.05). The hematoma clearance of patients 1 d and 3 d after operation in observation group were (83.24 ± 11.21) ml and (92.24 ± 15.63) ml, significantly higher than those in control group [(69.67 ± 10.73) ml and (85.57 ± 13.11) ml], and there were significant differences (P < 0.05). The incidence rates of intracranial rebleeding, intracranial infection and pulmonary infection in observation group were significantly lower than those in control group [2.63%(1/38) vs. 21.05%(8/38), 0 vs. 15.79% (6/38), 2.63%(1/38) vs. 21.05%(8/38)](P<0.05). After treatment for 3 months, the good prognosis rate in observation group was significantly higher than that in control group [86.84% (33/38) vs. 65.79% (25/38)] (P<0.05). Conclusions 3D-slicer software based on percutaneous soft-channel puncture and drainage for HICH patients can achieve better surgical results, reduce the incidence of complications and improve the prognosis of patients.
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Objective@#To investigate the success rate and safety of percutaneous vasoseminal vesiculography with the disposable vasographic interventional therapy kit (VITK).@*METHODS@#This study included ninety-six 19－65 (mean 43) years old male patients with infertility, hematospermia, seminal vesicle cyst, ejaculatory duct cyst, ejaculatory dysfunction, or vas deferens injury, with disease courses varying from 1 month to 7 years. With an open, multi-centered, single-group, self-controlled design and using the disposable VITK, we treated the patients by percutaneous vasoseminal vesiculography via injection of contrast medium into the vas deferens cavity under local anesthesia.@*RESULTS@#Percutaneous vasoseminal vesiculography was successfully performed in 92 (97.87%) of the patients, which revealed abnormal seminal ducts in 51 cases (54.3%). Among the 28 infertile patients, 3 were found with bilateral and 5 with unilateral vas deferens obstruction. Vesiculitis was detected in 36 (81.8%) of the 44 hematospermia patients and bilateral vas deferens abnormality in 5 (38.5%) of the 13 patients with ejaculatory dysfunction. Transectional damage was observed in 2 patients with vas deferens injury induced by bilateral inguinal hernia repair. Three cases of seminal vesicle cyst and 4 cases of ejaculatory cyst were definitely diagnosed by vasoseminal vesiculography.@*CONCLUSIONS@#The disposable vasographic interventional therapy kit, with the advantages of simple operation and high safety, deserves a wide clinical application in vasoseminal vesiculography.
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Adult , Aged , Humans , Male , Middle Aged , Young Adult , Contrast Media , Cysts , Diagnostic Imaging , Ejaculatory Ducts , Diagnostic Imaging , Genital Diseases, Male , Diagnostic Imaging , Hemospermia , Diagnostic Imaging , Hernia, Inguinal , General Surgery , Infertility, Male , Diagnostic Imaging , Injections , Postoperative Complications , Diagnostic Imaging , Radiography , Methods , Seminal Vesicles , Diagnostic Imaging , Vas Deferens , Diagnostic Imaging , Wounds and InjuriesABSTRACT
Objective To evaluate the curative effect and safety of percutaneous argon-helium knife cryoablation in treating patients with liver metastases from gastric cancer.Methods The clinical data of 24 patients with liver metastases from gastric cancer,who had received percutaneous argon-helium knife cryoablation therapy,were retrospectively analyzed.A total of 33 metastatic lesions could be used for evaluation.CT-guided percutaneous argon-helium knife cryoablation of liver metastases was carried out in all patients.The 3-month,6-month and 12-month local control rate,overall survival (OS) rate,progression -free survival (PFS),incidence of recurrence,preoperative and postoperative quality of life,and complications were documented.Results The median follow-up time was 14 months (6-48 months).After cryoablation therapy,the quality of life was improved significantly.The 3-month,6-month and 12-mouth local control rates were 91.7％,73.9％ and 52.6％ respectively.Mter cryoablation therapy,the median PFS was 8 months (1-16 months),the median survival time was 16 months,and the one-year and 2-year survival rates were 75.0％ and 37.5％ respectively.No severe complications occurred.Conclusion For the treatment of liver metastases from gastric cancer,percutaneous argon-helium knife cuoablation is safe and effective with reliable short-term curative effect,the patient's quality of life can be well improved.
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The purpose of the present work is to establish an ultra-minimal invasive percutaneous puncture inoculation method for a VX2 orthotopic lung cancer rabbit model with fewer technical difficulties, lower mortality of rabbits, a higher success rate and a shorter operation time, to evaluate the growth, metastasis and apoptosis of tumor by CT scans, necropsy, histological examination, flow cytometry and immunohistochemistry. The average inoculation time was 10–15 min per rabbit. The tumor-bearing rate was 100%. More than 90% of the tumor-bearing rabbits showed local solitary tumor with 2–10 mm diameters after two weeks post-inoculation, and the rate of chest seeding was only 8.3% (2/24). The tumors diameters increased to 4–16 mm, and irregularly short thorns were observed 3 weeks after inoculation. Five weeks post-inoculation, the liquefaction necrosis and a cavity developed, and the size of tumor grew further. Before natural death, the CT images showed that the tumors spread to the chest. The flow cytometry and immunohistochemistry indicated that there was less apoptosis in VX2 orthotopic lung cancer rabbit model compared to chemotherapy drug treatment group. Minimal invasive percutaneous puncture inoculation is an easy, fast and accurate method to establish the VX2 orthotopic lung cancer rabbit model, an ideal in situ tumor model similar to human malignant tumor growth.
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Humans , Rabbits , Apoptosis , Drug Therapy , Flow Cytometry , Immunohistochemistry , Lung Neoplasms , Lung , Methods , Mortality , Necrosis , Neoplasm Metastasis , Punctures , Thorax , Tomography, X-Ray ComputedABSTRACT
Objective To compare the puncturing hit rate,positive rate of pathological diagnosis and the incidence of complications between color Doppler ultrasound-guided and CT-guided percutaneous biopsy for the qualitative diagnosis of ultrasonic-visual chest lesions.Methods A total of 112 patients,who were encountered from January 2015 to June 2016 in authors' hospital and whose imaging materials suggested the presence of ultrasonic-visual chest lesions,were enrolled in this study.There were no bones or lung air between the thoracic skin and chest lesion to hinder imaging observation.Ultrasound-guided puncturing was employed in 52 patients (ultrasound-guided group) and CT-guided puncturing was adopted in 60 patients (CT-guided group).The puncturing hit rate,positive rate of pathological diagnosis and the incidence of complications were compared between the two groups.Results The puncturing hit rate in ultrasound-guided group was 100％ (52/52),which was higher than 91.7％ (55/60) in CT-guided group.The positive rate of pathological diagnosis in ultrasound-guided group was 96.2％ (50/52),which was higher than 80.0％ (48/60)in CT-guided group.The incidence of complications in ultrasound-guided group was 3.8％ (2/52),which was lower than 18.3％(11/60) in CT-guided group.Conclusion For the qualitative diagnosis of ultrasonic-visual chest lesions,ultrasound-guided percutaneous biopsy is more reliable than CT-guided percutaneous biopsy.
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Objective To investigate the diagnostic value of CT-guided percutaneous biopsy of peritoneum for unknown ascites.Methods The clinical data of 106 cases of unknown peritoneum in our hospital were collected retrospectively over the past five years (May 23,2011 to August 2,2016).The sensitivity and specificity of the percutaneous biopsy of peritoneum in diagnosis of the patients with unknown etiological ascites were evaluated.Complications were collected to evaluate the safety.Results The 106 patients with unknown ascites were performed with CT-guided percutaneous biopsy of peritoneum.The diagnoses of 91 patients were confirmed pathologically,accounted for 85.85％ of the total.Among the 91 patients,there were 60 cases (56.60％) of malignant and 31 cases (29.25％) of benign.The other 15 patients had no clinical diagnosis,which accounted for 14.15％ of the total.The diagnostic sensitivity and specificity was 88.35％ and 100％ respectively,which were significantly superior to cytological examination,biochemical markers and other routine analysis.No severe complications were observed in all patients.Conclusion CT-guided percutaneous biopsy of peritoneum for unknown ascites plays an important instructive role in diagnosis with high accuracy,and it is a safe and effective method.
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Objective:To discuss the clinical effects of implantation of radioative 125I seeds by the way of percutaneous puncture and laparotomy under the guidance of ultrasound in the treatment of locally advanced pancreatic cancer, and to provide the basis for choosing surgical methods in treating advanced pancreatic cancer.Methods:The clinical materials of 73 patients with advanced pancreatic cancer were collected, including 42 patients who underwent implantation of radioactive 125I seeds by percutaneous puncture(group A) and 31 patients who underwent impantation of radioactive 125I seeds by laparotomy(group B).The pain relief, local control of tumor, postoperative survival time and complications of the patients were compared between two groups. Results:The rates of pain relief of the patients in group A and group B were 91.89% and 86.40%,and there was no significant difference(P=0.815).The local control rates of the patients in group A and group B were 71.43% and 77.42% ,and there was no significant difference(P=0.564).The medium survival time of the patients in group A and group B were 11 months and 12 months;the one-year survival rates were 36.9% and 35.8%, and there was no significant difference(P=0.664).Seven patients in group A got fever;in group B, six patients got fever, two got calf muscle venous thrombosis, one got gastric retention, one got bilioentric anastomosis, one got abdominal distension and one got intestinal obstruction in the early stage after operation.The incidence rates of complications of the patients in two groups were 16.67% and 38.71%, and there was significant difference(P=0.034).Conclusion:Percutaneous implantation of radioactive 125I particles guided by ultrasound causes less complications in the treatment of locally advanced pancreatic cancer.Moreover, the percutaneous way reaches the same effect as the intraoperative way does on the pain relief, local control of tumor and survival time prolonged.
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Objective:To discuss the clinical value of CT-guided interstitial implantation of125I radioactive particle through the percutaneous puncture in the treatment of central-type lung cancer.Methods: 63 patients with the central-type lung cancer treated in Renmin Hospital of Wuhan University from November 2013 to July 2016 were randomly grouped (31 cases in the control group and 32 cases in the observation group). Patients in the control group were given the treatment of bronchial arterial perfusion with the chemotherapeutic drugs; while patients in the observation group were given the CT-guided interstitial implantation of125I radioactive particle through the percutaneous puncture. The clinical therapeutic effect and complications were observed of the two groups and the quality of life scores before and after the treatment were summarized between two groups as well.Results: The overall effective rate of observation group was 84.38% (27/32) that was higher than 61.29%(19/31) of control group, with statistical difference (x2=4.259,P0.05); the quality of life score of observation group after the treatment was 84.57±3.27 that was higher than 70.38±3.20 of control group, with statistical difference (t=17.402,P<0.05).Conclusion: CT-guided interstitial implantation of125I radioactive particle through the percutaneous puncture in the treatment of patients with central-type lung cancer has the significant effect, and it can effectively improve the quality of life for patients and have the high degree of safety.
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Objective To investigate the clinical effect of precise percutaneous radiofrequency ablation of semilunar ganglion through fo -ramen ovale under the three-dimensional CT for the treatment of trigeminal neuralgia .Methods A total of 80 patients with primary trigeminal neuralgia in our hospital from August 2013 to December 2015 were selected,and they were randomly divided into two groups with 40 cases in each group .The control group was implemented blind detective radiofrequency ablation ,while the observation group was carried out under the three-dimensional CT positioning radiofrequency ablation .All the patients were followed up for 3 months after treatment .Compared the overall clinical results , and recorded the time of targeting the trigeminal nerve and the complications within 1 week after treatment between the two groups.The pain condition at different time points (before treatment,1 week and 3 months after treatment) between the two groups were com-pared.Results The positioning time of observation group was shorter than that of the control group ,the difference was significant (P<0.05). The VAS score of the observation group 1 week and 3 months after surgery was lower than the control group ,the difference was significant (P<0.05).The ratio of masticatory muscle weakness ,hypoacusis,facial swelling and congestion and corneal anesthesia of the observation group within 1 week postoperatively were lower than those of the control group ,the difference was significant (P<0.05).The effective rate of the observation group was higher than that of the control group ,the difference was significant (P<0.05).Conclusion Percutaneous radiofre-quency ablation of semilunar ganglion through foramen ovale under the three -dimensional CT for the treatment of trigeminal neuralgia has the advantages of more accurate positioning of the foramen ovale ,shorter operation time , and less complications ,which can relieve the pain of pa-tients and improve the overall clinical effect .
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Objective To evaluate the effectiveness and safety of MRI-navigation system EMT-100 in assisting the performance of precise percutaneous puncture biopsy.Methods With the help of MRI-navigation system EMT-100,percutaneous puncture biopsy of thoracic and abdominal lesions was performed in 42 patients.The puncture success rate was used as the main index to evaluate the effectiveness of MRI-navigation system EMT-100.The success rate of puncture biopsy,the total time used for procedure,the average number of puncturing,the average number of scanning,and the incidence of complications were recorded.Results In the 42 patients,the success rates with single and twice puncturing were 86％ (36/42) and 14％ (6/42) respectively.The success rate of puncture biopsy was 100％.The mean time used for locating puncture site was (11.5±5.5) min;the average number of puncturing was (1.4±0.5) times,and the average number of scanningwas(4.2±0.8) times.Among the 32 patients with pulmonary lesions,bloody sputum occurred in 2 patients (6.2％) and small amount pneumothorax in one patient (3.1％),and no serious complications occurred in other patients.Conclusion In performing percutaneous puncture biopsy of thoracic and abdominal lesions,the use of MRI-navigation system is safe.This technique has certain advantages,such as accurate positioning,high puncture success rate,wide range of application,radiationless,etc.It can help precisely obtain the lesion tissue and get pathological diagnosis.Therefore,it is really a valuable guiding technology.(J Intervent Radiol,2017,26:263-265)
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Objective:To report one case of hilar hepatic tumor treated by ultrasound-guided percutaneous puncture 125 I radioactive seed implantation,and to review the associated literatures.Methods:One patient’s CT and ultrasonic examinations were taken,and the plan of TPS was taken.The patient was treated by ultrasound-guided percutaneous puncture 125 I radioactive seed implantation according to the plan of TPS.The needles were parallel, and the distance between the seeds were 1.0 to 1.5 cm. Results:The operation was successfully completed.No postoperative complications were encountered during 1 month follow up.The volume of tumor was obviously reduced 1 month after operation detected by ultrasound and CT. The local control effect of tumor was good.Conclusion:Ultrasound-guided percutaneous puncture 125 I radioactive seed implantation is a safe and effective method in treating hilar hepatic tumor.
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Objective:To observe curative effect of ultrasound guided celiac abscess puncture treatment, and evaluate the clinical curative effect of value.Methods: One hundred and twenty four cases with downward abdominal abscess puncture drainage guided by ultrasound and open drainage were collected randomly and divided into operation group and puncture group to explore the operation method and evaluate the postoperative effect.Results: The No. of puncture group with better curative effect of instituting is 49(79.0%), good effect No. is 11(17.7%), 2 cases (3.3%) got bad effect, fine rate was 96.8%; The No. of operation group with better curative effect of instituting is 10(16.1%), good effect No. is 31(50%), 21 cases(33.9%) got bad effect, fine rate was 66.1%; the results have significant difference(x2=19.270,P<0.01).Conclusion: Ultrasound-guided puncture can avoid blind puncture caused tissue damage, it has small trauma, simple operation, high safety. The characteristics of the curative effect is distinct, and has high value of clinical application.
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Objective: To evaluate the diagnosis value of percutaneous puncture biopsy technique under CT guiding in clinical pathological changes of breast. Methods:46 patients with breast lumps or nodules, including six cases of pleural disease, were carried out percutaneous puncture biopsy under CT guide, where a coaxial Angiotech 17G trocar together with BiopincelSG were used in the puncture process. Results: 44 cases of pathological findings were acquired and the diagnosis ratio was 93.4%, including 9 cases of squamous cell carcinoma, 24 cases of adenocarcinoma, 3 cases of small cell carcinoma, 1 case of metastatic tumor, 1 case of tuberculosis cases, 5 cases of inflammation and 1 case of normal reflexed pleura. 2 cases have no clear diagnosis. Conclusion: The percutaneous lung biopsy technique under CT guide has the merits of less diagnosis trauma, high diagnosis accuracy and high clinical application value.
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Objective To explore the safty and feasibility of transrectal ultrasound guided transperineal seminal vesicle biopsy in the evaluation of clinical staging of prostate cancer.Methods Retrospectively study 57 suspected prostate cancer patients with seminal abnormality during 2010.7-2015.1,age ranged from 50 to 78 years,average 65 ±7 years,serum total prostate specific antigen (tPSA) 3.2-131.1 μg/L, average (23.7 ± 11.3) μg/L.Twenty-two cases had palpable prostate nodules through rectal examination.All the 57 patients underwent ultrasound and template guided transperineal prostate and seminal vesicle puncture biopsies.Results Forty-four cases out of 57 found prostate cancer cells in biopsies, and 32 cases had seminal vesicle invasion (positive group) while the other 12 were negative.Twenty cases had been performed prostatectomy in the positive group and their post-operative pathological examination all showed prostate cancer with seminal vesicle invasion.Eleven cases in the negative group had been performed prostatectomy ,and 2 cases showed seminal vesicle invasion.The clinical stages of all cases in the positive group were considered as T3b both pre-operatively and post-operatively.In the negative group however, 11 cases were considered as T2 stage pre-operatively,while 2 cases were increased to T3b stage post-operatively.The sensitivity of puncturing seminal vesicle was 91％ (20/22) ,specificity was 100.0％ (9/9).Positive predictive value was 100.0％ (20/20),while negative predictive value was 82％ (9/11).All the 57 cases did not present fever after puncture biopsies, while 23 cases presented hematuria (40％) ,20 cases presented hemospermia (35％) and 1 case presented urinary retention (2％).Conclusions Transrectal ultrasound-guided transperinealseminal vesicle puncture is safe and reliable, it helps to improve the accuracy of pre-operative staging.
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Objective To discuss the safety of percutaneous puncture drainage for liver abscess in patients with blood coagulation dysfunction. Methods A total of 85 patients with liver abscess, who were admitted to authors’ hospital during the period from January 2013 to January 2014 to receive ultrasound-guided percutaneous puncture drainage, were included in this study. According to the international normalized ratio of prothrombin time≥1.5 and platelet count≤50 ×109/L, the patients were divided into group A (normal coagulation group,n=67) and group B (coagulation dysfunction group,n=18). The occurrence of postoperative complications was recorded and the results were compared between the two groups. Results In both groups, no statistically significant difference in hemoglobin level existed between preoperative level and postoperative one, and no bleeding complications occurred in all patients after the procedure. Conclusion For patients with liver abscess complicated by blood coagulation dysfunction, percutaneous puncture drainage treatment is safe and reliable.
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Objective To explore the clinical application of percutaneous puncture and drainage in treating pyogenic liver abscess. Methods A total of 30 patients with pyogenic liver abscess were treated with ultrasound-guided percutaneous puncture and aspiration of abscess cavity , which was followed by DSA-guided drainage tube placement together with proper washing of abscess cavity. Results Puncturing and flushing of abscess cavity was performed in two patients with 4 cm liver abscess. No severe complications occurred. Complete cure was obtained in all the 26 patients who had no malignant tumors. Of the 4 patients with malignant tumor, cure obtained in one and death occurred in three. Conclusion Ultrasound-guided or DSA-guided percutaneous puncture and drainage therapy is technically simple, less invasive, highly safe and clinically effective treatment for pyogenic liver abscess.
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Objective To investigate the effect of ultrasound- guided percutaneous injection of lauromacrogol in treating hepatic hemangiomas. Methods During the period from June 2010 to Jan. 2013 at authors’ hospital, a total of 32 patients with hepatic hemangiomas were treated with ultrasound-guided percutaneous injection of lauromacrogol. The largest lesion was 6.0 cm × 5.6 cm in size, and the smallest lesion was 3.0 cm × 2.6 cm in size. Before and after the treatment ultrasonography, hepatic functions and measurement of tumor size were performed, and the results were evaluated. Results A total of 54 times of puncturing were carried out for the 32 patients. Three times of puncturing were made in 2 cases , two times of puncturing in 18 cases, and single time of puncturing in 12 cases. Complete cure was achieved in 25 cases (78.1%) and effective result was obtained in 7 cases, with an effective rate of 100%. After the treatment, all patients complained of different degrees of pain at hepatic region, which were relieved spontaneously. Two patients developed fever (37.5 - 38.5℃), and after physical cooling the body temperature fell to normal within two days. One patient developed mild nausea and vomiting, which disappeared after symptomatic treatment. No severe complications occurred. Conclusion Ultrasound- guided percutaneous injection of lauromacrogol is a simple, safe and effective treatment for hepatic hemangiomas. Besides, this technique has no serious complications.