Operation Room Fire: Caution for Using Electrocautery after Rinsing Operation Field at the End of the Surgery with Alcohol-Based Cleansing Solutions

Efficacy of Endoscopic Electrocauterization for Recurrent Posterior Epistaxis

BACKGROUND AND OBJECTIVES: To investigate the common site of recurrent epistaxis after initial intervention such as packing and cauterization had failed and to evaluate the efficacy of surgical endoscopic electrocautery. SUBJECTS AND METHOD: Retrospective review of 47 patients with recurrent and uncontrolled idiopathic epistaxis between October 1995 and March 2016. All patients underwent endoscopic examination in the operating room after hospitalization. We performed electrocautery when a bleeding site was found. RESULTS: The most common sites of bleeding were the inferior meatus (28%), sphenoethmoid recess (23%), superior septum around the olfactory cleft (13%), and the posterior end of the middle turbinate (15%). There was no serious complication during the one week after surgery. In 46 (98%) patients, refractory epistaxis was successfully controlled. One patient had recurrent epistaxis after electrocautery and underwent endoscopic sphenopalatine artery ligation. CONCLUSION: In patients with refractory idiopathic epistaxis after failure of first-line treatment, endoscopic examination through a surgical approach and electrocautery for suspected bleeding are effective.

Effect of Electrocauterization on the Inflammation of the Conjunctiva in Experimental Animal Model

PURPOSE: Recently, conjunctivochalasis repair surgery using electrocauterization has been gaining popularity. However, patients with electrocauterized conjunctivoplasty tend to complain of more postoperative pain than patients undergoing simple excision with suturing. Therefore, we investigated the effects of electrocauterization on inflammation of the conjunctiva using an experimental animal model and compared these with the effects of simple excision with suturing. METHODS: Ten New Zealand white rabbits underwent cauterization in the right eyes and excision and suturing in the left eyes. For each eye, we excised or electrocauterized the inferior bulbar conjunctiva, 1 mm in width and 6 mm in length, 2 mm from the limbus. A fine-needle electrode was inserted subconjunctivally, and electrocauterization was performed. In the contralateral eye, the corresponding area was excised and re-approximated with 10-0 nylon sutures. Sutures were removed after 14 days. Tissue samples were obtained at 21 days post-procedure, and inflammatory cells were counted in five randomly selected fields (x200) on hematoxylin-eosin stained slides. Tumor necrosis factor (TNF)-alpha and interleukin (IL)-1beta concentrations in tears were measured using enzyme linked immunosorbent assays. RESULTS: All cauterized eyes demonstrated smooth surface healing without scarring after 5 days, whereas sutured eyes presented with mild edema with some scarring until the suture was removed. The number of inflammatory cells was significantly greater in sutured eyes compared with cauterized eyes (p = 0.035, Mann-Whitney U-test) at 21 days post-procedure. Tear TNF-alpha and IL-1beta concentrations at 21 days were similar in both groups. CONCLUSIONS: Electrocauterization for conjunctivoplasty seems to be advantageous in terms of inflammation compared with simple suturing and excision.

A Case of Tracheal Leiomyoma Treated by Electrosurgical Resection Under Rigid Bronchoscopy / 대한내과학회지

Leiomyoma of the tracheobroncheal tree is a very rare benign tumor of the lung. Airway obstructive symptoms can be similar to those of asthma; therefore, delayed or misdiagnosis is common. Although surgical resection with bronchoplastic reconstruction has long been the standard treatment, improvements in the technique have led to therapeutic bronchoscopy replacing surgery for treatment of benign tumors of the tracheobroncheal tree. We report a case of tracheal leiomyoma that was successfully resected under rigid bronchoscopy using an electrosurgical unit and bronchial snare.

A Case of Tracheal Leiomyoma Treated by Electrosurgical Resection Under Rigid Bronchoscopy / 대한내과학회지

Leiomyoma of the tracheobroncheal tree is a very rare benign tumor of the lung. Airway obstructive symptoms can be similar to those of asthma; therefore, delayed or misdiagnosis is common. Although surgical resection with bronchoplastic reconstruction has long been the standard treatment, improvements in the technique have led to therapeutic bronchoscopy replacing surgery for treatment of benign tumors of the tracheobroncheal tree. We report a case of tracheal leiomyoma that was successfully resected under rigid bronchoscopy using an electrosurgical unit and bronchial snare.

A Case of Congenital Duodenal Web Causing Duodenal Stenosis in a Down Syndrome Child: Endoscopic Resection with an Insulated-Tip Knife

A 35-month-old girl visited our hospital with repetitive vomiting and abdominal distention; this was especially aggravated after the introduction of solid and semisolid foods. At 5 months of age, the patient, who had Down's syndrome, had undergone surgery for ventricular septal defect, atrial septal defect, and patent ductus arteriosus, and had subsequently been frequently hospitalized for respiratory infections and other viral infectious diseases. After her admission, the abdominal distension improved with fasting and intravenous fl uid therapy. Radiograph from a small-bowel series revealed a thin fi lling defect with a dilated duodenal bulb in the distal region of the second portion of the duodenum, suggesting a duodenal web, and endoscopy revealed duodenal stenosis. We therefore performed endoscopic resection with an insulated-tip knife because of the history of prior operations, fasting problems after operations, and respiratory infections. Seven days later, scar formation was noted on the second portion of the duodenum, the scope passed well at the excision site, and no retained food material was noted on the follow-up endoscopy. After the procedure, the patient's abdominal distention and repetitive vomiting subsided, and she was discharged with the ability to eat eat an age-appropriate normal diet. There were no specifi c symptoms or other complications for 1 year after the procedure.

Effect of Electrocauterization on Corneal Astigmatism in Temporal Incision Cataract Surgery

This study was carried out to evaluate the effect of electrocauterization on corneal astigmatism after cataract operation with temporal incision. Forty-two eyes of patients undergoing routine phacoemulsification with one piece type polymethymethacrylate(PMMA) posterior chamber lens implantation with 6.0mm temporal scleral pocket incision and sutureless method by one surgeon were randomly selected Corneal astigmatism was evaluated for postoperative 3 months and analyzed by Cravy`s vector method. Both groups(electrocauterization group and no electrocauterization group) showed slight with-the-rule change of corneal astigmatism till postoperative 3 months and electrocauterization group showed +0.31D at postoperative 3 months but these differences were not statistically significant(student`s t-test: p=1.10). This results demonstrate that the scleral electrocauterization at temporal incision site induced more with-the-rule change than no cauterization group.