Role guided intraperitoneal port-a-cath insertion in the managment of cancer ovary of fluoroscopic

The use of intraperitoneal [IP] chemotherapy as a treatment for ovarian cancer has been demonstrated to result in improved survival. The aim of this work is to evaluate the applicability and efficacy of fluoroscopic placed intraperitoneal port-A-cath and to assess the response rate to intraperitoneal chemotherapy in cases of ovarian carcinoma. The studied group included, 22 female patients with malignant ovarian cancer whom referred from gynecological surgery and gynecological oncology units to the Vascular and Interventional Radiology Unit, Ain Shams University Hospitals, for peritoneal port-A-cath application. All the patients were known cases of either primary or recurrent ovarian cancer, underwent cytoreductive surgery and referred to us. Intraperitoneal port-A-cath with the aid of fluoroscopy showed highest technical success [91.9%] and lowest complication rate on the long run compared to other methods of peritoneal access. Patients with cancer ovary showed significant improvement of the disease process denoted by changes in the degree of ascites, peritoneal nodules and tumor marker level after receiving combined IV/ IP chemotherapy. Port catheters proved to be the most safe method of long term access to the peritoneal cavity with the lowest complication rate compared to other methods of access to the peritoneal cavity

Endoscopic control of acute gastroduodenal peptic ulcer bleeding

Emergency surgery for treatment of patients with acute gastro-duodenal bleeding still carries a significant risk. Non-surgical methods that are safe and reliably control major bleeding are therefore much warranted. The most promising of various non-operative methods under investigation seems to be endoscopic methods using electro-coagulation, injection, heater probe, or laser. In the present study we used endoscopy therapy for treatment of 104 patients with acute gastroduodenal bleeding. In 40 patients we used electrocoagulation and could achieve a permanent control of the bleeding in 32 patients [80%]. The endoscopic success rate in patients with gastric or duodenal ulcer was 87.5% and 75% respectively. In 64 patients we used injection therapy for control of bleeding and could achieve a permanent control in 44 patients [69%]. The endoscopic success rate in patients with gastric or duodenal ulcer was 76.2% and 61.7% respectively. Our results show that endoscopic hemostasis can be effective in treating patients with acute gastroduodenal bleeding and should be regarded as potential front line treatment. Diverse methods are available, and although no single technique has become firmly established, current evidence favour thermal coagulation and injection therapy