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Purpose: To assess the safety and efficacy of long intestinal tube placement following percutaneous image-guided esophagostomy for palliative decompression of incurable malignant small bowel obstruction.
Materials And Methods: Between January 2013 and June 2022, a single-institution retrospective study was conducted to examine patients undergoing percutaneous transesophageal intestinal intubation for an occluded intestinal segment. Patients' baseline characteristics, procedural details, and clinical courses were reviewed. Severe complications were defined as those with ≥ 4 grade according to the CIRSE classification.
Results: This study included 73 patients (mean age, 57.7 years) who underwent 75 procedures. All bowel obstructions were caused by peritoneal carcinomatosis or similar disease, which precluded transgastric access in almost 50% of the patients due to massive cancerous ascites (n = 28), diffuse gastric involvement (n = 5), or omental dissemination in front of the stomach (n = 3). Technical success (appropriate tube positioning) was achieved in 98.7% (74/75) of procedures. The cumulative 1-month overall survival and sustained clinical success (adequate bowel decompression) rates were estimated at 86.8% and 88%, respectively, using Kaplan-Meier analysis. At the median survival of 70 days, the disease progression required other gastrointestinal interventions, including additional tube insertion, repositioning, or venting enterostomy in 16 patients (21.9%). The severe complication rate was 4% (3/75); one patient aspirated to death due to tube clogging and two encountered fatal perforation of isolated intestinal loops developing far beyond the tip of the indwelling tube.
Conclusion: Percutaneous image-guided transesophageal intestinal intubation achieves feasible bowel decompression as palliative care in advanced cancer patients.
Level Of Evidence: Level 4, Case Series.
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http://dx.doi.org/10.1007/s00270-023-03457-3 | DOI Listing |
Int J Med Robot
December 2024
School of Automation, Nanjing University of Information Science and Technology, Nanjing, China.
Background: Percutaneous puncture procedures, guided by image-guided robotic-assisted intervention (IGRI) systems, are susceptible to disruptions in patients' respiratory rhythm due to factors such as pain and psychological distress.
Methods: We developed an IGRI system with a coded structured light camera and a binocular camera. Our system incorporates dual-pathway deep learning networks, combining convolutional long short-term memory (ConvLSTM) and point long short-term memory (PointLSTM) modules for real-time respiratory signal monitoring.
AJNR Am J Neuroradiol
December 2024
From the Department of Radiology (DGM., MVS., GMS., REG., JSR., TJR.) Mayo Clinic, Phoenix, AZ, USA; Department of Radiology (FED.), Mayo Clinic, Rochester, MN, USA. Department of Radiology (EHM.), Mayo Clinic, Jacksonville, FL, USA.
Background And Purpose: Studies show a modest yield for image-guided biopsy of suspected vertebral osteomyelitis-discitis. Many studies evaluate factors to improve diagnostic yield, and few studies assess how biopsy results impact clinical management. We aim to evaluate the impact of biopsy results on clinical management in suspected vertebral osteomyelitis-discitis.
View Article and Find Full Text PDFMed Phys
December 2024
ICube Laboratory, University of Strasbourg UMR 7357 CNRS, Strasbourg, France.
Background: Percutaneous image-guided cementoplasty is a medical procedure for strengthening bones structurally altered by disease, such as osteolytic metastasis. This procedure involves injecting biocompatible liquid bone cement, through one or more trocars into the damaged bone. Within a few minutes the bone cement hardens and restores the rigidity of the bony structure.
View Article and Find Full Text PDFThorac Cancer
December 2024
Department of Ultrasonography, Shanghai Pulmonary Hospital of Tongji University School of Medicine, Shanghai, China.
Background: This study aims to investigate the factors influencing false-negative results in ultrasound-guided percutaneous transthoracic needle lung biopsy results (US-PTLB).
Materials And Methods: This ambispective cohort study included patients with subpleural pulmonary lesions who underwent US-PTLB with benign pathological findings between April 2017 and June 2022 (retrospective cohort) and between July 2022 and October 2022 (prospective cohort). In the retrospective cohort, comparative and logistic regression analyses were performed to identify independent risk factors for false-negative biopsy results.
Diagnostics (Basel)
November 2024
Department of Diagnostic, Interventional and Pediatric Radiology, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 10, 3010 Bern, Switzerland.
Background/objectives: This study aimed to investigate pneumothorax risk, focusing on the gravitational effect of pleural pressure caused by specific patient positioning.
Methods: We retrospectively analyzed 144 percutaneous CT-guided lung biopsies performed between January 2019 and December 2023. Patients were grouped into those with or without pneumothorax.
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