Revolutionizing outcomes: endoscopic ultrasound-guided gallbladder drainage using innovative electrocautery enhanced-lumen apposing metal stents for high-risk surgical patients.

This study retrospectively evaluated the outcomes of endoscopic ultrasound-guided gallbladder drainage (EUS-GBD) using novel electrocautery-enhanced lumen-apposing metal stents (LAMS) in high-risk patients with acute cholecystitis (AC). Between January 1, 2021, and November 30, 2022, 58 high-risk surgical patients with AC underwent EUS-GBD with the novel electrocautery-enhanced LAMS. The technical success rate was 94.8% (55/58), with one case of duodenal perforation requiring surgery with complete stent migration and two of partial stent migration into the gallbladder. However, the clinical success rate was 100% (55/55). Recurrent AC occurred in 3.6% of the cases (2/55), managed with double pigtail plastic stents through the LAMS. Early AEs observed in 1.8% (1/55) due to stent obstruction. Late AEs occurred in 5.4% (3/55), including two cases of cholangitis and one of stent obstruction. For 33 patients followed over 6 months, LAMS maintenance was sustained in 30 cases. Two patients underwent double-pigtail plastic stent replacement after LAMS removal, and one underwent LAMS removal during surgery following tumor stage regression after chemotherapy for cholangiocarcinoma. The novel electrocautery-enhanced LAMS demonstrated high technical and clinical success rates in high-risk surgical patients with AC, maintaining effective gallbladder drainage with minimal AEs during long-term follow-up, thus highlighting its efficacy and safety in challenging patients.

Treatment of electroplating wastewater using electrocoagulation and integrated membrane.

Electroplating wastewater contains heavy metal ions and organic matter. These contaminants not only endanger the environment but also pose risks to human health. Despite the development of various treatment processes such as chemical precipitation MBR, electrocoagulation (EC) ceramic membrane (CM), coagulation ultrafiltration (UF) reverse osmosis (RO), and CM RO. These methods are only effective for low concentrations of heavy metals and struggle with high concentrations. To address the challenge of treating electroplating wastewater with high heavy metal content, this study focuses on the wastewater from Dongfang Aviation Machinery Processing Plant. It introduces an EC and integrated membrane (IM) treatment process for electroplating wastewater. The IM comprises microfiltration (MF) membrane, nanofiltration (NF) membrane, and RO membrane. Results indicated that under specific conditions, such as a pH of 8, current density of 5 A/dm2, electrode plate spacing of 2 cm, 35 min of electrolysis time, and influent pH of 10 for the IM, removal rates of Zn2+, Cu2+, Ni2+, and TCr in the wastewater exceeded 99%. The removal rates of chemical oxygen demand (COD), suspended solids (SS), total phosphorus (TP), total nitrogen (TN), and petroleum in wastewater exceed 97%. Following a continuous cleaning process, the membrane flux can consistently recover to over 94.3%.

A Retrospective Comparison of Low-Temperature Plasma Ablation and Radiofrequency Thermocoagulation of the Thoracic Nerve Root for Refractory Postherpetic Neuralgia.

BACKGROUND: Radiofrequency thermocoagulation (RFT) of the thoracic nerve root is commonly employed in treating medication-refractory thoracic post-herpetic neuralgia (PHN). However, RFT procedures' suboptimal pain relief and high occurrence of postoperative skin numbness present persistent challenges. Previous single-cohort research indicated that the low-temperature plasma coblation technique may potentially improve pain relief and reduce the incidence of skin numbness. Nevertheless, conclusive evidence favoring coblation over RFT is lacking. OBJECTIVES: To compare the clinical outcomes associated with coblation to those associated with RFT in the treatment of refractory PHN. STUDY DESIGN: Retrospective matched-cohort study. SETTING: Affiliated Hospital of Capital Medical University. METHODS: Sixty-eight PHN patients underwent coblation procedures between 2019 and 2020, and 312 patients underwent RFT between 2015 and 2020 in our department. A matched-cohort analysis was conducted based on the criteria of age, gender, weight, pain intensity, pain duration, side of pain, and affected thoracic dermatome. Pain relief was assessed using the numeric rating scale (NRS), the Medication Quantification Scale (MQS) Version III and the Neuropathic Pain Symptom Inventory (NPSI), which were employed to indicate pain intensity, medication burden, and comprehensive pain remission at 6, 12, and 24 months. Numbness degree scale scores and complications were recorded to assess safety. RESULTS: We successfully matched a cohort of 59 patients who underwent coblation and an equivalent number of patients who underwent RFT as a PHN treatment. At the follow-up time points, both groups' NRS, MQS, and NPSI scores exhibited significant decreases from the pre-operation scores (P < 0.05). The coblation group's NRS scores were significantly lower than the RFT group's at the sixth and the twenty-fourth months (P < 0.05). At 24 months, the MQS values in the coblation group were significantly lower than those in the RFT group (P < 0.05). Furthermore, the coblation group's total intensity scores on the NPSI were significantly lower than the RFT group's at the 12- and 24-month follow-ups (P < 0.05). At 6 months, the coblation group's temporary intensity scores on the NPSI were significantly lower than the RFT group's (P < 0.05). Notably, the occurrence of moderate or severe numbness in the coblation group was significantly lower than in the RFT group at 6 and 12 months (P < 0.05). No serious adverse effects were reported during the follow-up. LIMITATIONS: This analysis was a single-center retrospective study with a small sample size. CONCLUSION: In this matched cohort analysis, coblation achieved longer-term pain relief with a more minimal incidence rate of skin numbness than did RFT. Further randomized controlled trials should be conducted to solidify coblation's clinical superiority to RFT as a PHN treatment.

Retrogasserian trigeminal radiofrequency-thermorhizotmoy for trigeminal neuralgia.

Based on a personal experience of 4200 surgeries, radiofrequency thermocoagulation is useful lesional treatment for those trigeminal neuralgias (TNs) not amenable to microvascular decompression (idiopathic or secondary TNs). Introduced through the foramen ovale, behind the trigemnial ganglion in the triangular plexus, the needle is navigated by radiology and neurophysiological testing to target the retrogasserian fibers corresponding to the trigger zone. Heating to 55-75 °C can achieve hypoesthesia without anaesthesia dolorosa if properly controlled. Depth of anaesthesia varies dynamically sedation for cannulation and lesioning, and awareness during neurophysiologic navigation. Proper technique ensures long-lasting results in more than 75% of patients.

Stereoelectroencephalography-guided radiofrequency thermocoagulation of the epileptogenic zone: a potential treatment and prognostic indicator for subsequent excision surgery.

PURPOSE: To evaluate the safety and efficacy of stereoelectroencephalography (SEEG)-guided radiofrequency thermocoagulation (RFTC) for drug-resistant focal epilepsy and investigate the relationship between post-RFTC remission duration and delayed excision surgery effectiveness. METHODS: We conducted a retrospective analysis of 43 patients with drug-resistant focal epilepsy who underwent RFTC via SEEG electrodes. After excluding three, the remaining 40 were classified into subgroups based on procedures and outcomes. Twenty-four patients (60%) underwent a secondary excision surgery. We determined the predictive value of RFTC outcome upon subsequent surgical outcome by categorizing the delayed secondary surgery outcome as success (Engel I/II) versus failure (Engel III/IV). Demographic information, epilepsy characteristics, and the duration of seizure freedom after RFTC were assessed. RESULTS: Among 40 patients, 20% achieved Engel class I with RFTC alone, while 24 underwent delayed secondary excision surgery. Overall, 41.7% attained Engel class I, with a 66.7% success rate combining RFTC with delayed surgery. Seizure freedom duration was significantly longer in the success group (mean 4.9 months, SD = 2.7) versus the failure group (mean 1.9 months, SD = 1.1; P = 0.007). A higher proportion of RFTC-only and delayed surgical success group patients had preoperative lesional findings (p = 0.01), correlating with a longer time to seizure recurrence (p < 0.05). Transient postoperative complications occurred in 10%, resolving within a year. CONCLUSION: This study demonstrates that SEEG-guided RFTC is a safe and potential treatment option for patients with drug-resistant focal epilepsy. A prolonged duration of seizure freedom following RFTC may serve as a predictive marker for the success of subsequent excision surgery.

Transformation of dissolved organic matter during groundwater arsenite removal using air cathode iron electrocoagulation.

Dissolve organic matters (DOM) usually showed negative effect on the removal of inorganic arsenic (As) in groundwater by electrochemical approaches, yet which parts of sub-component within DOM played the role was lack of evidence. Herein, we investigated the effects of land-source humic-like acid (HA) on groundwater As(III) removal using air cathode iron electrocoagulation, based on the parallel factor analysis of three-dimensional excitation-emission matrix and statistical methods. Our results showed that the land-source HA contained five kinds of components and all components presented significantly negative correlations with the removal of both As(III) and As(V). However, the high aromatic fulvic-like acid and low aromatic humic-like acid components of land-source HA presented the opposite correlations with the concentration of As(III) during the reaction. The high aromaticity fulvic-like components of land-source HA (Sigma-Aldrich HA, SAHA) produced during the reaction facilitated the oxidation of As(III) due to its high electron transfer capacities and good solubility in wide pH range, but the low aromaticity humic-like ones worked against the oxidation of As(III). Our findings offered the novel insights for the flexible activities of DOM in electron Fenton system.

Comparison of the effect of ultrasounic-harmonic scalpel and electrocautery in the treatment of axillary lymph nodes during radical surgery for breast cancer.

OBJECTIVE: To compare the efficacy of ultrasounic-harmonic scalpel and electrocautery in the treatment of axillary lymph nodes during radical surgery for breast cancer. METHODS: A prospective study was conducted in the Department of Breast Surgery, Zhongda Hospital Affiliated to Southeast University. A total of 128 patients with pathologically confirmed breast cancer who were treated by the same surgeon from July 2023 to November 2023 were included in the analysis. All breast operations were performed using electrocautery, and surgical instruments for axillary lymph nodes were divided into ultrasounic-harmonic scalpel group and electrocautery group using a random number table. According to the extent of lymph node surgery, it was divided into four groups: sentinel lymph node biopsy, lymph node at station I, lymph node at station I and II, and lymph node dissection at station I, II and III. Under the premise of controlling variables such as BMI, age and neoadjuvant chemotherapy, the effects of ultrasounic-harmonic scalpel and electrocautery in axillary surgery were compared. RESULTS: Compared with the electrosurgical group, there were no significant differences in lymph node operation time, intraoperative blood loss, postoperative axillary drainage volume, axillary drainage tube indwelling time, postoperative pain score on the day after surgery, and the incidence of postoperative complications (p>0.05). CONCLUSION: There is no significant difference between ultrasounic-harmonic scalpel and electrocautery in axillary lymph node treatment for breast cancer patients, which can provide a basis for the selection of surgical energy instruments.

Degradation of the neonicotinoid pesticide imidacloprid by electrocoagulation and ultrasound.

Imidacloprid is still a widely used neonicotinoid insecticide that is banned in many countries because of the associated environmental risks. Due to the inefficiency of conventional wastewater treatments for pesticide removal, new treatment methods are being investigated. Electrochemical methods, including electrocoagulation (EC), seem to be promising alternatives considering their effectiveness in removing various pollutants from wastewater. The aim of this study was to investigate the effects of electrode material, current density, ultrasound, and operation time on the efficiency of imidacloprid removal from a model solution by EC. The combination of aluminum electrodes and 20 A of applied current for 20 min resulted in total imidacloprid degradation. A simplified energy balance was introduced as a form of process evaluation. Combining ultrasound with EC resulted in 7% to 12% greater efficacy than using only EC.

Treatment of tomato paste wastewater by electrochemical and membrane processes: process optimization and cost calculation.

This study investigated the treatment of wastewater from tomato paste (TP) production using electrocoagulation (EC) and electrooxidation (EO). The effectiveness of water recovery from the pretreated water was then investigated using the membrane process. For this purpose, the effects of independent control variables, including electrode type (aluminum, iron, graphite, and stainless steel), current density (25-75 A/m2), and electrolysis time (15-120 min) on chemical oxygen demand (COD) and color removal were investigated. The results showed that 81.0% of COD and 100% of the color removal were achieved by EC at a current density of 75 A/m2, a pH of 6.84 and a reaction time of 120 min aluminum electrodes. In comparison, EO with graphite electrodes achieved 55.6% of COD and 100% of the color removal under similar conditions. The operating cost was calculated to be in the range of $0.56-30.62/m3. Overall, the results indicate that EO with graphite electrodes is a promising pretreatment process for the removal of various organics. In the membrane process, NP030, NP010, and NF90 membranes were used at a volume of 250 mL and 5 bar. A significant COD removal rate of 94% was achieved with the membrane. The combination of EC and the membrane process demonstrated the feasibility of water recovery from TP wastewater.

Simultaneous electrocoagulation and E-peroxone coupled with ultrafiltration membrane for shale gas produced water treatment.

Membrane fouling caused by the organics-coated particles was the main obstacle for the highly efficient shale gas produced water (SGPW) treatment and recycling. In this study, a novel hybrid electrocoagulation (EC) and E-peroxone process coupled with UF (ECP-UF) process was proposed to examine the efficacy and elucidate the mechanism for UF fouling mitigation in assisting SGPW reuse. Compared to the TMP (transmembrane pressure) increase of -15 kPa in the EC-UF process, TMP in ECP-UF system marginally increased to -1.4 kPa for 3 filtration cycles under the current density of 15 mA/cm2. Both the total fouling index and hydraulically irreversible fouling index of the ECP-UF process were significantly lower than those of EC-UF process. According to the extended Derjaguin-Landau-Verwey-Overbeek theory, the potential barriers was the highest for ECP-UF processes due to the substantial increase of the acid-base interaction energy in ECP-UF process, which was well consistent with the TMP and SEM results. Turbidity and TOC of ECP-UF process were 63.6% and 45.8% lower than those of EC-UF process, respectively. According to the MW distribution, the variations of compounds and their relative contents were probably due to the oxidation and decomposing products of the macromolecular organics. The number of aromatic compound decreased, while the number of open-chain compounds (i.e., alkenes, alkanes and alcohols) increased in the permeate of ECP-UF process. Notably, the substantial decrease in the relative abundance of di-phthalate compounds was attributed to the high reactivity of these compounds with ·OH. Mechanism study indicated that ECP could realize the simultaneous coagulation, H2O2 generation and activation by O3, facilitating the enhancement of ·OH and Alb production and therefore beneficial for the improved water quality and UF fouling mitigation. Therefore, the ECP-UF process emerges as a high-efficient and space-saving approach, yielding a synergistic effect in mitigating UF fouling for SGPW recycling.

Monopolar stereoelectroencephalography-guided radiofrequency thermocoagulation.

OBJECTIVE: Stereoelectroencephalography (SEEG)-guided radiofrequency thermocoagulation (RFTC) has the advantage of producing a lesion in the epileptogenic zone (EZ) at the end of SEEG. The majority of published SEEG-guided RFTCs have been bipolar and usually performed between contiguous contacts of the same electrode. In the present study, the authors evaluate the safety, efficacy, and benefits of monopolar RFTC at the end of SEEG. METHODS: This study included a series of 31 consecutive patients who had undergone RFTC at the end of SEEG for drug-resistant focal epilepsy in the period of January 2013-December 2019. Post-RFTC seizure control was assessed after 2 months and at the last follow-up visit. Twenty-one patients underwent resective epilepsy surgery after the SEEG-guided RFTC, and the postoperative seizure outcome among these patients was compared with the post-RFTC seizure outcome. RESULTS: Four hundred forty-six monopolar RFTCs were done in the 31 patients. Monopolar RFTCs were performed in all cortical areas, including the insular cortex in 11 patients (56 insular RFTCs). There were 31 noncontiguous lesions (7.0%) because of vascular constraints. The volume of one monopolar RFTC, as measured on T2-weighted MRI immediately after the procedure, was between 44 and 56 mm3 (mean 50 mm3). The 2-month post-RFTC seizure outcomes were as follows: seizure freedom in 13 patients (41.9%), ≥ 50% reduced seizure frequency in 11 (35.5%), and no significant change in 7 (22.6%). Seizure outcome at the last follow-up visit (mean 18 months, range 2-54 months) showed seizure freedom in 2 patients (6.5%) and ≥ 50% reduced seizure frequency in 20 patients (64.5%). Seizure freedom after monopolar RFTC was not significantly associated with the number or location of coagulated contacts. Seizure response after monopolar RFTC had a high positive predictive value (93.8%) but a low negative predictive value (40%) for seizure outcome after subsequent resective surgery. In this series, the only complication (3.2%) was a limited intraventricular hematoma following RFTC performed in the hippocampal head, with spontaneous resolution and no sequelae. CONCLUSIONS: The use of monopolar SEEG-guided RFTC provides more freedom in terms of choosing the SEEG contacts for thermocoagulation and a larger thermolesion volume. Monopolar thermocoagulation seems particularly beneficial in cases with an insular EZ, in which vascular constraints could be partially avoided by making noncontiguous lesions within the EZ.

Advancements in hemostatic strategies for managing upper gastrointestinal bleeding: A comprehensive review.

Upper gastrointestinal (GI) hemorrhage presents a substantial clinical challenge. Initial management typically involves resuscitation and endoscopy within 24 h, although the benefit of very early endoscopy (< 12 h) for high-risk patients is debated. Treatment goals include stopping acute bleeding, preventing rebleeding, and using a multimodal approach encompassing endoscopic, pharmacological, angiographic, and surgical methods. Pharmacological agents such as vasopressin, prostaglandins, and proton pump inhibitors are effective, but the increase in antithrombotic use has increased GI bleeding morbidity. Endoscopic hemostasis, particularly for nonvariceal bleeding, employs techniques such as electrocoagulation and heater probes, with concerns over tissue injury from monopolar electrocoagulation. Novel methods such as Hemospray and Endoclot show promise in creating mechanical tamponades but have limitations. Currently, the first-line therapy includes thermal probes and hemoclips, with over-the-scope clips emerging for larger ulcer bleeding. The gold probe, combining bipolar electrocoagulation and injection, offers targeted coagulation but has faced device-related issues. Future advancements involve combining techniques and improving endoscopic imaging, with studies exploring combined approaches showing promise. Ongoing research is crucial for developing standardized and effective hemorrhage management strategies.

Optimizing electrocoagulation for poultry slaughterhouse wastewater treatment: a fuzzy axiomatic design approach.

White meat consumption is increasing day by day, and accordingly, there is an increase in the amount of wastewater resulting from the processes. Today, the reuse of wastewater has become a goal within the scope of the Green Deal. For this reason, wastewater treatment with high pollution and volume has gained importance. In this study, the fuzzy axiomatic design (FAD) method, one of the multi-criteria decision-making methods, has been used. With this method, coagulation, electrocoagulation (EC), dissolved air flotation (DAF), and anaerobic treatment alternatives preferred in poultry slaughterhouse wastewater (PSW) treatment were compared with each other and their information contents were calculated. The information content from the smallest to the largest is EC, DAF, coagulation, and anaerobic treatment, respectively. This treatment method was chosen because the smallest information content is in electrocoagulation. EC was applied to bloody PSW containing 1% blood by volume. The effectiveness of Fe and Al electrodes for PSW treatment in the batch EC reactor has been compared. The effective surface areas of 2 anodes and 2 cathodes connected bipolarly in the processes are 288 cm2. The electrolyte, pH, time, and current density effects on energy consumption were also investigated. The optimum conditions for Al and Fe electrodes were found to be 0.5 g·L-1 NaCl concentration, pH 5, 0.639 mA·cm-2 current density, and 5 min time. Under optimum conditions for the Fe electrode, COD, TOC, TN, and oil-grease removal efficiencies were determined as 76.3%, 71.8%, 70%, and 74%, respectively. Moreover, the highest COD, TOC, TN, and oil-grease removal efficiencies were achieved with an Al electrode (82.2%, 82.3%, 82.7%, and 78.9%, respectively). The experimental data were fit to a variety of isotherms and kinetic models to determine the characteristics of the EC. The results indicated that the pseudo-second-order equation provided the best fit for COD removal. Under optimum conditions, the operating cost was calculated as $3.39 and $3.09 for Al and Fe electrodes, respectively. In this study, the fuzzy axiomatic design method was used for the first time to select the most appropriate treatment method for PSW. In addition, blood, a major problem for the poultry slaughterhouse industry, was mixed with PSW at a ratio of 1% (v/v) and treated with EC for the first time with high removal efficiency. By treating PSW, which has a high pollution load, with electrocoagulation, the pollution load of the water to be given to secondary treatment has been greatly reduced.

Investigation of the removal of diclofop methyl herbicide by peroxy electrocoagulation process and kinetic and cost analysis.

Pesticides containing chlorine, which are released during agricultural activities, are chemical substances that mix with surface and underground waters and have toxic, carcinogenic, and mutagenic effects on the entire living ecosystem. Due to their chemically stable structure, conventional water and wastewater treatment techniques such as coagulation, flocculation, and biological oxidation do not entirely remove these chemical substances. Therefore, before releasing them into the environmental receptor, these chemical substances must be transformed into harmless products or mineralized through advanced oxidation processes. When we look at the literature, there are not many studies on methods of removing diclofop methyl from aquatic media. Our study on the removal of diclofop methyl herbicide from aquatic media using the peroxy electrocoagulation method will provide the first information on this subject in the literature. In addition, this treatment method will contribute significantly to filling an important gap in the literature as an innovative approach for diclofop methyl removal. Moreover, peroxy electrocoagulation, which produces less sludge, provides treatment in a short time, and is economical, has been determined to be an advantageous process. The effects of conductivity, pH, H2O2 concentration, current, and time parameters on the removal of diclofop methyl were investigated using a GC-MS instrument. Kinetics, energy consumption, and cost calculations were also made. Under the optimum conditions determined (pH = 5, H2O2 = 500 mg/L, NaCl = 0.75 g/L, current density = 2.66 mA/cm2), the peroxydic electrocoagulation process resulted in a diclofop methyl removal efficiency of 79.2% after a 25-min reaction. When the experimental results were analyzed, it was found that the results fitted the pseudo-second-order kinetic model.

Integration of sequential electrocoagulation and adsorption for effective removal of colour and total organic carbon in textile effluents and its utilization for seed germination and irrigation.

Textile effluent discharge can negatively impact the environment and living organisms due to its potential toxicity, higher percentages of total organic carbon (TOC) contents, and so on. The study investigates the extraordinary performance of the electrocoagulation process (ECP) combined with powdered activated carbon (PAC) as a highly effective and environmental friendly method of treating textile effluents. This scientific work mainly includes the focus on removing toxic components in textile effluents, such as high concentrations of colour and TOC using synthesized PAC derived from coconut shells coupled with the ECP (ECP-PAC). Initially, PAC was characterized by using XRD, Raman, BET, FTIR, and TGA studies. Subsequently, the pilot-scale ECP-PAC batch reactor was constructed with iron (Fe) as an anode and copper (Cu) as a cathode. The pilot-scale ECP-PAC batch reactor has achieved higher treatment efficiency in a shorter reaction time with low energy consumption compared to a stand-alone ECP. Further, the optimum conditions for effective ECP-PAC have been optimized, such as pH 7.5, applied current density (0-50 mA/cm2), reaction time (0-30 min), electrode combinations (Fe-Cu) with electrode distances of 5 cm apart, and an optimum dose of 5 g/L of PAC. Specifically, 98% of the colour and 96% of the TOC contents present in the industrial textile effluent were treated in 15 and 30 min, respectively. In quantitative perspectives, the developed batch reactor has sharply decreased TOC (324.1 mg/L), IC (1410 mg/L) and TC (1019 mg/L) to 13.55 mg/L (96%), 31.49 mg/L (97%), and 48.05 mg/L (95%), respectively, in 30 min demonstrating its sensitivity and selectivity with the utmost care. Moreover, the physicochemical properties of the treated water were convincingly assessed. That is, it remains suitable for the seed germination of mung bean and chlorophyll content study. Thus, the developed methodology could effectively reduce freshwater consumption in the agricultural sector, increase freshwater availability in water-scarce regions, and facilitate the increase of the recharging capacity of groundwater tables.

[How good are we really? Incidence of postoperative bleeding requiring intervention and intraoperative electrocoagulation during Thulium laser enucleation of the prostate]. / Wie gut sind wir wirklich? Interventionsbedürftige Nachblutungen und intraoperative Elektrokoagulationen bei der Thulium-Laser-Enukleation der Prostata.

The need for intervention due to postoperative bleeding represents a significant complication in Thulium Laser Enucleation of the Prostate (ThuLEP). This study aimed to retrospectively analyse this complication in the treatment of benign prostatic enlargement. This study focuses on investigating potential causative factors for postoperative bleeding requiring intervention as well as the use of intraoperative electrocoagulation. A total of 503 ThuLEP procedures performed between 08/2021 and 07/2022 were examined. Postoperatively, 4.2% (n=21) of patients experienced bleeding requiring intervention. Study data revealed a significant association between these instances of bleeding and a high prostate volume (p=0.004), high enucleation weight (p=0.004), and intraoperative electrocoagulation (p=0.048). In total, intraoperative electrocoagulation was applied in 41.2% (n=207) of cases. In these cases, statistically significant factors leading to the application of electrocoagulation included intraoperative capsule perforation (p=0.005) and high enucleation weight (p=0.002).

Comparison of initial percutaneous balloon compression versus radiofrequency thermocoagulation followed by percutaneous balloon compression in the treatment of trigeminal neuralgia. / 首次经皮球囊压迫术与射频热凝术后再行经皮球囊压迫术治疗三叉神经痛的比较.

OBJECTIVES: There are a variety of minimally invasive interventional treatments for trigeminal neuralgia, and the efficacy evaluation is different. The preferred treatment scheme is still controversial. This study aims to investigate the differences in treatment effects between patients with primary trigeminal neuralgia (PTN) treated with percutaneous balloon compression (PBC) for the first intervention and patients with pain recurrence after radiofrequency thermocoagulation (RT) who then received PBC for PTN, and to offer clinicians and patients more scientifically grounded and precise treatment alternatives. METHODS: We retrospectively analyzed 103 patients with PTN admitted to the Department of Pain Management of the Second Affiliated Hospital of Guangxi Medical University from January 2020 to December 2021, including 49 patients who received PBC for the first time (PBC group) and 54 patients who received PBC for pain recurrence after RT (RT+PBC group). General information, preoperative pain score, intraoperative oval foramen morphology, oval foramen area, balloon volume, duration of compression, and postoperative pain scores and pain recurrence at each time point on day 1 (T1), day 7 (T2), day 14 (T3), 1 month (T4), 3 months (T5), and 1 year (T6) were collected and recorded for both groups. The differences in treatment effect, complications and recurrence between the 2 groups were compared, and the related influencing factors were analyzed. RESULTS: The differences of general information, preoperative pain scores, foramen ovale morphology, foramen ovale area, T1 to T3 pain scores between the 2 groups were not statistically different (all P>0.05). The balloon filling volume in the PBC group was smaller than that in the RT+PBC group, the pain scores at T4 to T6 and pain recurrence were better than those in the RT+PBC group (all P<0.05). Pain recurrence was positively correlated with pain scores of T2 to T6 (r=0.306, 0.482, 0.831, 0.876, 0.887, respectively; all P<0.01). CONCLUSIONS: The choice of PBC for the first intervention in PTN patients is superior to the choice of PBC after pain recurrence after RT treatment in terms of treatment outcome and pain recurrence.

El humo del electrocauterio, el riesgo olvidado y minimizado de la cirugía / Smoke from electrocautery, the forgotten and minimized risk of surgery

Introducción. La nueva era de la cirugía es cada vez más dependiente de la tecnología, y un ejemplo de ello es el uso generalizado de electrocauterio como parte primordial de la práctica quirúrgica. El humo quirúrgico es un subproducto de la disección y la coagulación de los tejidos producidas por los equipos de energía, que representa múltiples riesgos potenciales para la salud del grupo quirúrgico, sin embargo, se han minimizado los peligros causados por la exposición de manera frecuente y acumulativa a este aerosol. Métodos. Se realizó un análisis crítico, desde una posición reflexiva de la información disponible, estableciendo los posibles riesgos relacionados con la exposición al humo quirúrgico. Discusión. Es visible la necesidad imperativa de establecer directrices nacionales, pautas normativas y recomendaciones estandarizadas para cumplir con las exigencias dadas por los sistemas de gestión en salud ocupacional y seguridad del trabajo, cuyo objetivo principal es hacer efectivo el uso de mascarillas quirúrgicas apropiadas, la implementación de programa de vigilancia epidemiológica ambiental en sala de cirugía, la priorización del uso constante de aspiradores y sistemas de evacuación, y la ejecución de programas educativos de sensibilización dirigidos al personal implicado. De igual manera, se abre la inquietud de la necesidad de nuevos estudios para definir con mayor precisión el peligro de este aerosol. Conclusión. Se recomienda de manera responsable utilizar todas las estrategias preventivas existentes para intervenir en salas de cirugía los riesgos minimizados y olvidados del humo quirúrgico.

Introduction. The new era of surgery is increasingly dependent on technology, and an example of this is the widespread use of electrocautery as a primary part of surgical practice. Surgical smoke is a byproduct of the dissection and coagulation of tissues produced by energy equipment, which represents multiple potential health risks for the surgical group; however, the dangers caused by cumulative exposure have been minimized. Methods. A critical analysis was carried out from a reflective position of the available information, establishing the possible risks related to exposure to surgical smoke. Discussion. The imperative need to establish national normative guidelines and standardized recommendations to comply with the demands given by the occupational health and work safety management systems, whose main objective is to make effective the use of appropriate surgical masks, implementation of environmental epidemiological surveillance program in the operating room, prioritizing the constant use of vacuum cleaners and evacuation systems, and carrying out educational awareness programs aimed at the personnel involved. Likewise, there is concern about the need for new studies to more precisely define the danger of this aerosol. Conclusion. It is recommended to responsibly use all existing preventive strategies to intervene in operating rooms to minimize the forgotten risks of surgical smoke.

Argon Plasma Coagulation as Treatment for Anal Condylomas: A Narrative Review.

OBJECTIVES: Anal condylomas are a manifestation of anal human papillomavirus infection and can be associated with precancerous lesions and squamous cell carcinomas. Several methods have been described for treatment, including argon plasma coagulation. A narrative review of the evidence published on this topic was conducted. METHODS: A search was conducted using PubMed, Scopus, and Web of Science databases. RESULTS: Five studies reported on anal/perianal condyloma treatment with argon plasma coagulation. In 3 of these studies, there was a comparison with other treatment methods (addition of imiquimod, electrofulguration, and electrocautery, respectively). Argon plasma coagulation settings varied between studies. This type of treatment was effective for ablation. Recurrence rates and follow-up times varied largely between studies. No major complications, such as pain, scarring, sexual dysfunction, or severe bleeding were described. CONCLUSION: Studies indicate that argon plasma coagulation is an effective and safe therapy for anal and perianal condylomas.