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Clinical application of reserved gastric tube in neuroendoscopic endonasal surgery for pituitary tumor

World Journal of Clinical Oncology 2024年第3期15卷 411-418页

作者： Xi Chen Long-Yao Zhang Zhi-Feng Wang Yi Zhang Yu-Hua Yin Xue-Jian Wang Department of Nursing Affiliated Hospital 2 of Nantong UniversityNantong 226000Jiangsu ProvinceChina Department of Neurosurgery Affiliated Hospital 2 of Nantong UniversityNantong 226000Jiangsu ProvinceChina Department of Neurosurgery Renji HospitalShanghai Jiao Tong UniversityShanghai 226000China

BACKGROUND The neuroendoscopic approach has the advantages of a clear operative field,convenient tumor removal,and less damage,and is the development direction of modern neurosurgery.At present,transnasal surgery for sphenoidal pituitary tumor is widely used.But it has been found in clinical practice that some patients with this type of surgery may experience post-operative nausea and vomiting and other discomforts.AIM To explore the effect of reserved gastric tube application in the neuroendoscopic endonasal resection of pituitary tumors.METHODS A total of 60 patients who underwent pituitary adenoma resection via the endoscopic endonasal approach were selected and randomly divided into the experimental and control groups,with 30 in each group.Experimental group:After anesthesia,a gastric tube was placed through the mouth under direct vision using a visual laryngoscope,and the fluid accumulated in the oropharynx was suctioned intermittently with low negative pressure throughout the whole process after nasal disinfection,during the operation,and when the patient recovered from anesthesia.Control group:Given the routine intraoperative care,no gastric tube was left.The number of cases of nausea/vomiting/aspiration within 24 h post-operation was counted and compared between the two groups;the scores of pharyngalgia after waking up,6 h post-operation,and 24 h postoperation.The frequency of postoperative cerebrospinal fluid leakage and intracranial infection were compared.The hospitalization days of the two groups were statistically compared.RESULTS The times of postoperative nausea and vomiting in the experimental group were lower than that in the control group,and the difference in the incidence of nausea was statistically significant(P<0.05).After the patient woke up,the scores of sore throat 6 h after the operation and 24 h after operation were lower than those in the control group,and the difference was statistically significant(P<0.05).The number of cases of postoperative cerebrospinal fluid leakage and intracran

关键词： Neuroendoscopy Endonasal approach Pituitary tumor Reserved gastric tube Nausea Vomiting aspiration Complications

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Impact of glucagon-like peptide receptor agonists on endoscopy and its preoperative management: Guidelines, challenges, and future directions

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World Journal of Gastrointestinal Endoscopy 2024年第6期16卷 292-296页

作者： Sahib Singh Vishnu Charan Suresh Kumar Ganesh Aswath Department of Internal Medicine Sinai HospitalBaltimoreMD 21215United States Division of Gastroenterology and Hepatology State University of New York Upstate Medical UniversitySyracuseNY 13210United States

Glucagon-like peptide receptor agonists(GLP-1RA)are used to treat type 2 diabetes mellitus and,more recently,have garnered attention for their effect-iveness in promoting weight loss.They have been associated with several gastrointestinal adverse effects,including nausea and vomiting.These side effects are presumed to be due to increased residual gastric contents.Given the potential risk of aspiration and based on limited data,the American Society of Anesthesi-ologists updated the guidelines concerning the preoperative management of patients on GLP-1RA in 2023.They included the duration of mandated cessation of GLP-1RA before sedation and usage of“full stomach”precautions if these medications were not appropriately held before the procedure.This has led to additional challenges,such as extended waiting time,higher costs,and increased risk for patients.In this editorial,we review the current societal guidelines,clinical practice,and future directions regarding the usage of GLP-1RA in patients undergoing an endoscopic procedure.

关键词： Glucagon-like peptide receptor agonists Endoscopy Adverse events Intubation aspiration Semaglutide Healthcare burden Guidelines

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Percutaneous aspiration and sclerotherapy of a giant simple hepatic cyst causing obstructive jaundice:A case report and review of literature

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World Journal of Gastrointestinal Surgery 2022年第7期14卷 706-713页

作者： Xu-Xia He Mei-Xing Sun Ke Lv Jian Cao Sheng-Yu Zhang Jing-Nan Li Department of Gastroenterology Peking Union Medical College HospitalBeijing 10000China Department of Ultrasound Peking Union Medical College HospitalBeijing 10000China Department of Radiology Peking Union Medical College HospitalBeijing 10000China

BACKGROUND Giant simple hepatic cysts causing intrahepatic duct dilatation and obstructive jaundice are uncommon.A variety of measures with different clinical efficacies and invasiveness have been developed.Nonsurgical management,such as percutaneous aspiration and sclerotherapy,is often applied.CASE SUMMARY The case is a 39-year-old female with a 5-mo history of cutaneous and scleral icterus,loss of appetite,and dark urine.Lab tests showed jaundice and liver function abnormalities.Imaging revealed a giant simple hepatic cyst obstructing the intrahepatic bile ducts.A combination of percutaneous catheter aspiration and lauromacrogol sclerotherapy was successfully performed and the effects were satisfactory with the size of cyst decreasing from 13.7 cm×13.1 cm to 3.0 cm×3.0 cm.Further literature review presented the challenges of managing giant simple hepatic cysts that cause obstructive jaundice and compared the safety and efficacy of a combination of percutaneous aspiration and lauromacrogol sclerotherapy with other management strategies.CONCLUSION Giant simple hepatic cysts can cause obstructive jaundice,and a combination of percutaneous catheter aspiration and sclerotherapy with lauromacrogol are suggested to treat such cases.

关键词： Simple hepatic cyst Obstructive jaundice aspiration Sclerotherapy Lauromacrogol Case report

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aspiration therapy for acute embolic occlusion of the superior mesenteric artery

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World Journal of Gastroenterology 2019年第7期25卷 848-858页

作者： Yi-Ren Liu Zhu Tong Cheng-Bei Hou Shi-Jun Cui Lian-Rui Guo Yi-Xia Qi Li-Xing Qi Jian-Ming Guo Yong-Quan Gu Department of Vascular Surgery Xuanwu Hospital Capital Medical University Center of Evidence-Based Medicine Xuanwu Hospital Capital Medical University

BACKGROUND Embolic superior mesenteric artery(SMA) occlusion is associated with high mortality rates. Delayed treatment often leads to serious consequences, including intestinal necrosis, resection, and even patient death. Endovascular repair is being introduced, which can improve clinical symptoms and prognosis and decrease the incidence of exploratory laparotomy. Many reports have described successful endovascular revascularization of embolic SMA occlusion. However,most of those reports are case reports, and there are few reports on Chinese patients. In this paper, we describe the technical and clinical outcomes of aspiration therapy using a guiding catheter and long sheath technique which facilitates the endovascular repair procedure.AIM To evaluate the complications, feasibility, effectiveness, and safety of endovascular treatment for the acute embolic occlusion of the SMA.METHODS This retrospective study reviewed eight patients(six males and two females)from August 2013 to October 2018 at Xuanwu Hospital, Capital Medical University. The patients presented with acute embolic occlusion of the SMA on admission and were initially diagnosed by computed tomography angiography(CTA). The patients who underwent endovascular treatment with a guiding catheter had no obvious evidence of bowel infarct. No intestinal necrosis was identified by gastrointestinal surgeons through peritoneal puncture or CTA. The complications, feasibility, effectiveness, safety, and mortality were assessed.RESULTS Six(75%) patients were male, and the mean patient age was 70.00 ± 8.43 years(range, 60-84 years). The acute embolic occlusion of the SMA was initially diagnosed by CTA. All patients had undertaken anticoagulation primarily, and percutaneous aspiration using a guiding catheter was then undertaken because the emboli had large amounts of thrombus residue. No death occurred among the patients. Complete patency of the suffering artery trunk was achieved in six patients, and defect filling was accomplished in two patients. The in-hospital

关键词： Superior mesenteric artery Acute embolic occlusion aspiration embolectomy Transcatheter thrombolysis Endovascular repair

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aspiration of coagulated hematoma in the third and fourth ventricles via paracele anterior horn puncture

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Chinese Journal of Traumatology 2016年第1期19卷 28-30页

作者： Zhi-Qiang Tao Sheng-Hong Ding Department of Neurosurgery Yiwu Central Hospital Wenzhou Medical College Yiwu 32200 Zhejiang Province China

Intraventricular hemorrhage (IVH) is a neurological urgency with a high mortality and unfavorable prognosis. Fast removal of intraventricular blood should be considered as a priority. The current treatments of IVH mainly focus on external ventricular drain and endoscopic aspiration, but neither way can remove the blood in the fourth ventricle easily and relieve the compression of brainstem. Here we report a unique procedure to solve this problem. A 41-year-old male patient who had suffered sudden attack of headache and disturbance of consciousness for 2 h was diagnosed as having high density lesion in the whole ventricular system by computed tomographic (CT) imaging. An emergent bilateral ventriculopuncture and intraventricular hematoma removal under non-line-of-sight was performed immediately; the catheter was extended to the fourth ventricle to maximally remove the hematoma. Postoperative CT scan demonstrated total removal of IVH and no sign of extra brain damage.

关键词： Intraventricular hemorrhage Ventriculopuncture aspiration Non-line-of-sight

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Push vs pull method for endoscopic ultrasound-guided fine needle aspiration of pancreatic head lesions: Propensity score matching analysis

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World Journal of Gastroenterology 2018年第27期24卷 3006-3012页

作者： Mitsuru Sugimoto Tadayuki Takagi Rei Suzuki Naoki Konno Hiroyuki Asama Yuki Sato Hiroki Irie Ko Watanabe Jun Nakamura Hitomi Kikuchi Yuichi Waragai Mika Takasumi Minami Hashimoto Yuko Hashimoto Takuto Hikichi Hiromasa Ohira Department of Gastroenterology Fukushima Medical UniversitySchool of Medicine Department of Endoscopy Fukushima Medical University Hospital Department of Diagnostic Pathology Fukushima Medical University

AIM To evaluate the efficacy of endoscopic ultrasoundguided fine needle aspiration(EUS-FNA) of pancreatic head cancer when pushing(push method) or pulling the echoendoscope(pull method).METHODS Overall, 566 pancreatic cancer patients had their first EUS-FNA between February 2001 and December 2017. Among them, 201 who underwent EUS-FNA for pancreatic head lesions were included in this study. EUS-FNA was performed by the push method in 85 patients, the pull method in 101 patients and both the push and pull methods in 15 patients. After propensity score matching(age, sex, tumor diameter, and FNA needle), 85 patients each were stratified into the push and pull groups. Patient characteristics and EUSFNA-related factors were compared between the two groups.RESULTS Patient characteristics were not significantly different between the two groups. The distance to lesion was significantly longer in the push group than in the pull group(13.9 ± 4.9 mm vs 7.0 ± 4.9 mm, P < 0.01). The push method was a significant factor influencing the distance to lesion(≥ median 10 mm)(P < 0.01). Additionally, tumor diameter ≥ 25 mm(OR = 1.91, 95%CI: 1.02-3.58, P = 0.043) and the push method(OR = 1.91, 95%CI: 1.03-3.55, P = 0.04) were significant factors contributing to the histological diagnosis of malignancy.CONCLUSION The pull method shortened the distance between the endoscope and the lesion and facilitated EUS-FNA of pancreatic head cancer. The push method contributed to the histological diagnosis of pancreatic head cancer using EUS-FNA specimens.

关键词： Endoscopic ultrasound-guided fine needle aspiration Pancreatic head Pancreatic cancer Push method Pull method

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Adult with mass burnt lime aspiration: A case report and literature review

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World Journal of Clinical Cases 2021年第32期9卷 9935-9941页

作者： Xin-Yu Li Hai-Jia Hou Bing Dai Wei Tan Hong-Wen Zhao Department of Respiratory and Critical Care Medicine The First Affiliated Hospital of China Medical UniversityShenyang 110001Liaoning ProvinceChina

BACKGROUND Foreign body aspiration mainly occurs in children,which can cause a severe concurrent syndrome and even death without timely treatment.As a rare foreign body,aspiration of lime is seldom reported,and most cases involve a small amount of hydrated lime.Although the symptoms are usually severe,the prognosis is good after suitable treatment.Experience of treatment for lime aspiration is lacking,and this report provides novel evidence for treatment of mass burnt lime aspiration using bronchoscopy.CASE SUMMARY We report an adult with a large amount of burnt lime aspiration.Because of delay in clearance of the inhaled lime in the trachea and bronchus at the local hospital,he suffered several severe complications,including complete occlusion of the right primary bronchus,aeropleura,aerodermectasia,pneumomediastinum,secondary infection and hypoxemia at 4 d after injury.After transferring to our department,bronchoscopy was immediately carried out to clear the lime in the major airway,using foreign body forceps,biopsy forceps,puncture needle,and hairbrush.The patient’s condition recovered rapidly and at 3-months’follow-up,he demonstrated good recovery of the bronchus and lung parenchyma.CONCLUSION After mass lime aspiration,flexible fiberoptic bronchoscopy is suggested as early as possible,using clamping,flushing or cryotherapy.

关键词： Burnt lime aspiration Bronchial obstruction Flexible fiberoptic bronchoscopy Computed tomography Case report

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Endoscopic ultrasound-guided fine-needle aspiration biopsy-Recent topics and technical tips

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World Journal of Clinical Cases 2019年第14期7卷 1775-1783页

作者： Kazuya Matsumoto Yohei Takeda Takumi Onoyama Soichiro Kawata Hiroki Kurumi Hiroki Koda Taro Yamashita Hajime Isomoto Division of Internal Medicine Irisawa Medical ClinicMatsue 690-0025Japan Department of Multidisciplinary Internal Medicine Tottori UniversityYonago 683-8504Japan

Endoscopic ultrasound-guided fine-needle aspiration biopsy (EUS-FNA) is a useful procedure that enables reliable pathological diagnoses of pancreatobiliary diseases, subepithelial lesions, and swollen lymph nodes. In recent years, a pathological diagnosis based on EUS-FNA has made it possible to provide accurate treatment methods not only in these fields, but also in respiratory organs and otorhinolaryngology. This review discusses the latest topics pertaining to EUS-FNA as well as procedural tips.

关键词： Endoscopic ultrasound-guided fine-needle aspiration biopsy Cytology Pathology Pancreatobiliary diseases Subepithelial lesions Lymph nodes

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In vitro investigation of a new thrombus aspiration and autologous blood reinfusion system

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Journal of Interventional Medicine 2019年第1期2卷 12-15页

作者： Weixiao Li Qiang Li Shuiting Zhai Tianxiao Li Nick Cheshire Zhidong Zhang Kai Liang Department of Vascular and Endovascular Surgery Henan Provincial People's HospitalZhengzhou University People's HospitalChina Department of Medical Imaging Henan Provincial People's HospitalZhengzhou University People's HospitalChina Department of Interventional Radiology Henan Provincial People's HospitalZhengzhou University People's HospitalChina Department of Vascular Surgery Royal Brompton&Harefield NHS Foundation TrustImperial College LondonChina

Purpose: The aim of the study was to evaluate the feasibility of a new venous-thrombus aspiration and autologous blood(auto-blood) reinfusion system.Materials and methods: We constructed the venous model from polyvinyl chloride(PVC) tubes and three-way unions using a fresh clot of chicken blood as the venous thrombus. Eight French and 12 F aspiration catheters were used to aspirate the thrombus in the right–pulmonary-artery model, 8 French and 14 F aspiration catheters were used in the inferior–vena cava model, and 8 French and 10 F aspiration catheters were used in the left-–iliofemoral-vein model. A thrombus filtration and auto-blood reinfusion bottle was used to filter the thrombus and re-infuse auto-blood. We evaluated the thrombus aspiration capability of each catheter by comparing preaspirated with the post-aspirated thrombus volume, and we evaluated the difference in aspiration capability between the two catheters in each model by comparing their thrombus aspiration rates. We used Student’s t-test for statistical analysis.Results: Differences between pre-aspirated and post-aspirated thrombus volumes for each catheter were insignificant, as were those between the thrombus aspiration rates of the two catheters in each venous model. Using the thrombus aspiration and auto-blood reinfusion system, each aspiration catheter could fluently aspirate the thrombus out of the venous model.Conclusion: In this study, we designed a new venous-thrombus aspiration system. This system could be used to aspirate acute venous thrombi and re-infuse autologous blood.

关键词： Deep-venous thrombosis Manual aspiration thrombectomy Percutaneous mechanical thrombectomy Autologous blood reinfusion aspiration catheter

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Ultrasound guided testicular fine needle aspiration in buck (Capra hircus)-An animal model

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Asian pacific Journal of Reproduction 2017年第1期6卷 26-31页

作者： Sattwikesh Paul Nasrin Sultana Juyena Shonkor Kumar Das Raihana Nasrin Ferdousy Rahul Deb Sarker Soheli Jahan Mou Department of Surgery and Radiology Faculty of Veterinary Medicine and Animal ScienceBangabandhu Sheikh Mujibur Rahman AgriculturalUniversityGazipurBangladesh Department of Surgery and Obstetrics Faculty of Veterinary ScienceBangladesh Agricultural UniversityMymensingh Department of Anatomy and Histology Faculty of Veterinary ScienceBangladesh Agricultural UniversityMymensingh Department of Pathology Faculty of Veterinary ScienceBangladesh Agricultural UniversityMymensingh.

Objective:To establish ultrasound guided testicular fine needle aspiration (TFNA) as well as to assess the effectiveness of uni-directional (UD) and multi-directional (MD) TFNA in buck according to testicular cells, echotexture and gross changes of testicle, age of buck was considered.Methods:A total of 120 samples were collected with both directions (UD, n=60) and (MD,n=60) suction from testis of 10 apparently healthy bucks. All slides were stained with May-Grünwald-Giemsa and examined under light microscope with 1000× magnifications to count spermatogenic cells, spermatozoa and sertoli cells. The percentage of spermatozoa and sertoli cells were expressed as spermatic index and sertoli cell index.Results:Results revealed no difference in the presence of various spermatogenic and sertoli cells in cell cluster of slides made either unidirectional TFNA or multidirectional TFNA. Early spermatids were the most numerous, followed by late spermatids, primary spermatocytes, spermatogonia. Sertoli cell index was higher in TFNA smears of young bucks prepared from (7-13 mo) of age and spermatic index was higher in adult bucks (14-24 mo) of age. No echogenic change was observed in the echotexture of testisafter TFNA.Conclusion: It seems that TFNA has no serious ill effect on the buck testis when uni-direction aspiration is performed. Moreover, the possibility to standardize this method might provide a greater impulse to the clinical diagnostics of male animal infertility.

关键词： Testicular fine needle aspiration Spermatic index Sertoli cell index

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