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Vargas A, Dutta P, Carpenter ES, Machicado JD. Endoscopic Ultrasound-Guided Ablation of Premalignant Pancreatic Cysts and Pancreatic Cancer. Diagnostics (Basel) 2024; 14:564. [PMID: 38473035 DOI: 10.3390/diagnostics14050564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Revised: 02/29/2024] [Accepted: 03/04/2024] [Indexed: 03/14/2024] Open
Abstract
Pancreatic cancer is on the rise and expected to become the second leading cause of cancer-related death by 2030. Up to a one-fifth of pancreatic cancers may arise from mucinous pancreatic cysts, which are frequently present in the general population. Currently, surgical resection is the only curative approach for pancreatic cancer and its cystic precursors. However, only a dismal proportion of patients are eligible for surgery. Therefore, novel treatment approaches to treat pancreatic cancer and precancerous pancreatic cysts are needed. Endoscopic ultrasound (EUS)-guided ablation is an emerging minimally invasive method to treat pancreatic cancer and premalignant pancreatic cysts. Different ablative modalities have been used including alcohol, chemotherapy agents, and radiofrequency ablation. Cumulative data over the past two decades have shown that endoscopic ablation of mucinous pancreatic cysts can lead to cyst resolution in a significant proportion of the treated cysts. Furthermore, novel data are emerging about the ability to endoscopically ablate early and locally advanced pancreatic cancer. In this review, we aim to summarize the available data on the efficacy and safety of the different EUS-ablation modalities for the management of premalignant pancreatic cysts and pancreatic cancer.
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Affiliation(s)
- Alejandra Vargas
- Department of Medicine, Eastern Virginia Medical School, Norfolk, VA 23510, USA
| | - Priyata Dutta
- Department of Medicine, Trinity Health, Ann Arbor, MI 48197, USA
| | - Eileen S Carpenter
- Division of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, MI 48109, USA
| | - Jorge D Machicado
- Division of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, MI 48109, USA
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Yoon S, Kwak J, Im D, Yoon H. Review of outcomes of using lower ethanol concentration (83%) in percutaneous ultrasound-guided renal cyst sclerotherapy in dogs. J Vet Sci 2023; 24:e61. [PMID: 37638709 PMCID: PMC10556289 DOI: 10.4142/jvs.23045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 05/26/2023] [Accepted: 06/26/2023] [Indexed: 08/29/2023] Open
Abstract
BACKGROUND Percutaneous renal cyst sclerotherapy (PRCS) as a treatment for renal cysts is usually performed with a high concentration of ethanol (≥ 90%). This study reviewed cases in which a lower concentration of ethanol (83%) was used for the procedure in dogs. METHODS Records of cases of renal cysts treated by sclerotherapy using 83% ethanol in dogs were reviewed. Outcomes of the treatment were evaluated by comparing volumes of renal cysts before the procedure and the volumes after treatment, using ultrasound images with the volume reduction rates classified as follows: < 50% of initial volume (failed); ≥ 50% but < 80% of initial volume (partial success); ≥ 80% but < 95% of initial volume (great success); ≥ 95% of initial volume (complete success). RESULTS Out of nine dog kidneys, renal cysts sclerotherapy with 83% ethanol achieved partial success in one kidney, great success in four, and complete success in the other four. No side effect was observed. The mean of the volume-reduction rates was 90.00 ± 11.00 while the minimum and maximum reduction rates were 65% and 100%, respectively. CONCLUSIONS The lower ethanol concentration (83%) is good for disinfecting kidneys in PRCS.
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Affiliation(s)
- Sanghyeon Yoon
- Department of Veterinary Medical Imaging, College of Veterinary Medicine, Jeonbuk National University, Iksan 54596, Korea
| | - Jungmin Kwak
- Department of Veterinary Medical Imaging, College of Veterinary Medicine, Konkuk University, Seoul 05029, Korea
| | - Deokho Im
- Nel Animal Medical Center, Anyang 14065, Korea
| | - Hakyoung Yoon
- Department of Veterinary Medical Imaging, College of Veterinary Medicine, Jeonbuk National University, Iksan 54596, Korea.
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Kim JH, Jeon UB, Jang JY, Kim TU, Ryu H, Yeom JA, Roh J. Efficacy of single-session 99.5% ethanol sclerotherapy for incidentally found simple renal cysts. Medicine (Baltimore) 2022; 101:e32114. [PMID: 36550842 PMCID: PMC9771283 DOI: 10.1097/md.0000000000032114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Simple renal cysts are the most common masses in the kidney. Most are asymptomatic and are incidentally detected on imaging examinations performed for other reasons. This study aimed to compare the results of 40 and 120 minutes ethanol sclerotherapies that were performed in a single session to treat incidentally found simple renal cysts. We retrospectively reviewed 63 renal cysts in 62 patients treated by single session percutaneous ethanol sclerotherapy. Thirty-one patients with 32 cysts underwent a 40 minutes sclerotherapy (group A), and 31 patients with 31 cysts underwent a 120 minutes retention technique (group B). Under ultrasonographic and fluoroscopic guidance, cystic fluid was completely aspirated, and 50% of the aspirated volume was replaced with 99.5% ethanol (a maximum of 100 mL). Imaging follow-up of the patients was performed 3 months after sclerotherapy. The technical success rates were 100% in both groups. Eighteen patients (29.0%) were symptomatic (flank pain or discomfort). Indications of the other patients were large cysts (>5 cm; 46%) and an increment in the diameter on serial studies (25.4%). A significant difference between the 2 groups in terms of age, cyst diameter, volume of aspirated fluid, volume of injected ethanol, and percentage of reduction in cyst diameter (P > .05) was not found. After treatment, flank pain or discomfort resolved in 17 of 18 (94.4%) symptomatic patients. One patient complained of persistent flank pain; however, no significant abnormality was detected on post-procedural computed tomography images. There were no other complications after therapy in the 2 groups. Single session ethanol sclerotherapy with a 40 minutes retention technique is an effective, safe, and cost-effective method for the treatment of incidentally found simple renal cysts. Although the procedural time was reduced, there was no significant difference in therapeutic efficacy between the 40 and 120 minutes therapies.
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Affiliation(s)
- Jin Hyeok Kim
- Department of Radiology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Ung Bae Jeon
- Department of Radiology, Pusan National University Yangsan Hospital, Yangsan, Korea
- Department of Radiology, School of Medicine, Pusan National University, Yangsan, Korea
- * Correspondence: Ung Bae Jeon, Department of Radiology, Pusan National University Yangsan Hospital, 20 Geumo-ro, Mulgeum-eup, Yangsan, Gyeongnam 50612, Korea (e-mail: )
| | - Joo Yeon Jang
- Department of Radiology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Tae Un Kim
- Department of Radiology, Pusan National University Yangsan Hospital, Yangsan, Korea
- Department of Radiology, School of Medicine, Pusan National University, Yangsan, Korea
| | - Hwaseong Ryu
- Department of Radiology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Jeong A Yeom
- Department of Radiology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Jieun Roh
- Department of Radiology, Pusan National University Yangsan Hospital, Yangsan, Korea
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Giurazza F, Marra P, Mosconi C, Corvino F, Corvino A, Niola R. Primary non-parasitic splenic cyst: US- and fluoroscopy-guided percutaneous management by alcohol sclerosis on six patients. JOURNAL OF CLINICAL ULTRASOUND : JCU 2022; 50:1360-1367. [PMID: 36053957 DOI: 10.1002/jcu.23298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Revised: 06/13/2022] [Accepted: 07/04/2022] [Indexed: 06/15/2023]
Abstract
PURPOSE This manuscript aims to report on a retrospective analysis of six patients treated with combined US- and fluoroscopic-guided percutaneous alcohol sclerosis for primary non-parasitic splenic cysts. METHODS In this retrospective analysis, three females and three males affected by primary non-parasitic splenic cysts were included. All except one were symptomatic. Preoperative cyst diameter was in mean 113 mm (range: 67-210 mm). Ethanol 96% was adopted as sclerosant agent; the amount of ethanol injected corresponded to the 20%-30% of the cystic volume. US follow-up was planned at 2/4 weeks; MR follow-up was conducted almost at 6 months after the last treatment session. Technical success was considered as cyst disappearance or reduction of the maximum diameter <50 mm; clinical success, in those symptomatic cases, was considered as symptoms resolution or marked improvement. RESULTS Eleven procedures had been performed: one in three patients, three in two patients and two in one patient. Technical success was 83.3%; clinical success was 80%. Only one patient, with a preoperative cystic diameter of 210 mm and despite three treatment sessions, had an increase in the cystic size and did not report symptoms improvement. CONCLUSIONS In this sample, US-guided percutaneous alcohol sclerosis was a safe and effective spleen preserving option to treat primary non-parasitic splenic cysts.
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Affiliation(s)
- Francesco Giurazza
- Department of Vascular and Interventional Radiology, Cardarelli Hospital, Naples, Italy
| | - Paolo Marra
- Department of Diagnostic Radiology, Giovanni XXIII Hospital, Milano-Bicocca University, Bergamo, Italy
| | - Cristina Mosconi
- Radiology Unit, Department of Specialized, Diagnostic and Experimental Medicine, DIMES, University Hospital of Bologna Sant'Orsola-Malpighi Polyclinic, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Fabio Corvino
- Department of Vascular and Interventional Radiology, Cardarelli Hospital, Naples, Italy
| | - Antonio Corvino
- Motor Science and Wellness Department, University of Naples "Parthenope", Naples, Italy
| | - Raffaella Niola
- Department of Vascular and Interventional Radiology, Cardarelli Hospital, Naples, Italy
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Lee E, Badger C, Mamidi IS, Benito DA, Li L, Goodman JF, Thakkar PG, Joshi A. Ultrasound-guided ethanol sclerotherapy for multifocal unilateral Warthin's tumor after partial parotidectomy. ULTRASOUND (LEEDS, ENGLAND) 2022; 30:158-161. [PMID: 35509301 PMCID: PMC9058389 DOI: 10.1177/1742271x211030302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 06/12/2021] [Indexed: 05/03/2023]
Abstract
Introduction Warthin's tumor, also known as papillary cystadenoma lymphomatosum, is one of the most common benign salivary gland neoplasms. The current first-line treatment for Warthin's tumor is parotidectomy. However, surgical resection has the risk of complications including facial nerve weakness and Frey's syndrome. Recently, ultrasound-guided ethanol sclerotherapy (UGES) has been found to be efficacious in the treatment of a variety of head and neck lesions. Case report We present a patient with multifocal Warthin's tumor who was managed with partial parotidectomy and two cycles of ultrasound-guided ethanol sclerotherapy. Discussion Ethanol sclerotherapy has been used as a minimally invasive alternative to surgical excision or observation alone for a variety of head and neck masses. To our knowledge, this is the first case presented in the literature where sclerotherapy was used in conjunction with a partial parotidectomy. Minimizing the extent of surgical resection can reduce the risk of facial nerve weakness and Frey's syndrome and negate the need for fat grafting for defect reconstruction. Conclusion UGES may serve as a safe and reliable procedure that can be performed in conjunction with partial parotidectomy for patients who wish to achieve definitive diagnosis while also minimizing the risk of complications associated with extensive parotidectomy.
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Affiliation(s)
- Esther Lee
- Division of Otolaryngology-Head and Neck Surgery, George Washington University School of Medicine & Health Sciences, Washington, DC and Western University of Health Sciences, Pomona, CA, USA
- Esther Lee, Division of Otolaryngology-Head and Neck Surgery, George Washington University School of Medicine & Health Sciences, Western University of Health Sciences, Pomona, CA, USA.
| | - Christopher Badger
- Division of Otolaryngology-Head and Neck Surgery, George Washington University School of Medicine & Health Sciences, Washington, DC, USA
| | - Ishwarya S Mamidi
- Division of Otolaryngology-Head and Neck Surgery, George Washington University School of Medicine & Health Sciences, Washington, DC, USA
| | - Daniel A Benito
- Division of Otolaryngology-Head and Neck Surgery, George Washington University School of Medicine & Health Sciences, Washington, DC, USA
| | - Lilun Li
- Division of Otolaryngology-Head and Neck Surgery, George Washington University School of Medicine & Health Sciences, Washington, DC, USA
| | - Joseph F Goodman
- Division of Otolaryngology-Head and Neck Surgery, George Washington University School of Medicine & Health Sciences, Washington, DC, USA
| | - Punam G Thakkar
- Division of Otolaryngology-Head and Neck Surgery, George Washington University School of Medicine & Health Sciences, Washington, DC, USA
| | - Arjun Joshi
- Division of Otolaryngology-Head and Neck Surgery, George Washington University School of Medicine & Health Sciences, Washington, DC, USA
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Kobayashi K, Yoneyama S, Iwasa E, Karibe J, Yamashita D, Takizawa A. A case involving laparoscopic decortication of a large simple renal cyst using conventional monopolar device. Int J Surg Case Rep 2022; 92:106866. [PMID: 35240486 PMCID: PMC8889350 DOI: 10.1016/j.ijscr.2022.106866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 02/21/2022] [Accepted: 02/22/2022] [Indexed: 12/04/2022] Open
Abstract
Introduction and importance Simple renal cysts are common in adults, but most of them are asymptomatic. Usually, percutaneous puncture is an initial treatment, but laparoscopic decortication may be effective for recurrent simple renal cyst. Herein, we report a case in which a large symptomatic simple renal cyst was treated with laparoscopic decortication using conventional monopolar device. Case presentation A 34-year-old female visited our hospital with chief complaints of back pain and abdominal fullness. Computed tomography showed a right simple renal cyst (diameter: 140 mm). We performed percutaneous drainage with sclerotherapy, but the cyst recurred a month later. Thus, we carried out laparoscopic decortication. We opened the cyst wall via a retroperitoneal approach and trimmed it using monopolar scissors. The operation time was 124 min. The patient's postoperative course was uneventful, and no complications were observed. Following surgery, the patient was asymptomatic. Clinical discussion In our case, we performed operation using a conventional monopolar device without sealing devices. It has been reported that the use of sealing devices can make laparoscopic surgery safer and reduce the operation time, but we herein report that laparoscopic decortication with a conventional monopolar device is an effective and safe treatment option for symptomatic simple renal cysts and that more expensive energy sources are not required. Conclusion We successfully performed laparoscopic decortication of a large symptomatic simple renal cyst. This operation is minimally invasive and safe. Simple renal cyst are common and most cases are asymptomatic, but large simple renal cyst may cause symptoms such as pain. As an initial treatment, percutaneous puncture is widely performed, but recurrence rates are high. Laparoscopic decortication may be an effective and safe treatment option for large symptomatic simple renal cysts.
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Alrashidi I, Shin JH. Percutaneous Transhepatic and Translumbar Sclerotherapy of a Thoracic Duct Cyst: A Case Report. THE ARAB JOURNAL OF INTERVENTIONAL RADIOLOGY 2021. [DOI: 10.1055/s-0041-1730116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
AbstractA 58-year-old male presented with chronic abdominal pain lasting 5 years and a 15 × 6-cm multicystic thoracic duct cyst with three compartments, located in the right retrocrural and retrocardiac regions from T5/T6 to T12/L1. A transhepatic route was selected to sclerose the middle and lower compartments. Subsequent contrast injection showed minimal contrast passage into the upper compartment through a narrow neck, but the guidewire could not pass into this compartment. The contrast-filled upper compartment was punctured with a 22-g Chiba needle using a translumbar approach under cone-beam computed tomography (CT) guidance and ethanol sclerotherapy was performed. Six-month follow-up CT revealed decreased thoracic duct cyst size (5×3 cm) and no pain. This case illustrates successful percutaneous transhepatic and translumbar sclerotherapy for retrocardiac and retrocrural thoracic duct cysts, which are very difficult to remove surgically.
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Affiliation(s)
- Ibrahim Alrashidi
- Department of Radiology, University of Ulsan, College of Medicine Asan Medical Center, Songpa-gu, Seoul, Republic of Korea
| | - Ji Hoon Shin
- Department of Radiology, University of Ulsan, College of Medicine Asan Medical Center, Songpa-gu, Seoul, Republic of Korea
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Cárdenas-Vargas MI, Ortiz MI, Izquierdo-Vega J, Díaz-Zamudio M. Sustained volume decreases in simple renal cysts after sclerotherapy using NBCA with or without hydrodissection. J Interv Med 2021; 4:15-20. [PMID: 34805942 PMCID: PMC8562247 DOI: 10.1016/j.jimed.2020.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 09/28/2020] [Accepted: 10/10/2020] [Indexed: 11/17/2022] Open
Abstract
The present study aimed to determine the effectiveness of sclerotherapy using NBCA (Histoacryl Blue®; B. Braun, Melgungen, Germany), with or without hydrodissection, for the treatment of simple renal cysts. Materials and Methods: Patients who presented to an interventional radiology clinic for the diagnosis of symptomatic renal cysts which had previously been identified at an outpatient clinic were selected for inclusion in this study. A total of 28 patients were randomly divided into 2 groups, based on whether or not they underwent hydrodissection along with ultrasound-guided NBCA-based sclerotherapy. Sonographs were performed at 0, 7, and 180 days post-procedure to record the residual volume of the renal cysts and to determine the efficacy of the procedure. Results: A total of 32 cysts in 28 patients were treated with sclerotherapy, 18 (64%) females and 10 (36%) males. The average age of the patients was 61.8 years (range: 33-89 years). All patients reported an improvement in symptoms associated with the existing renal cysts at 7 and 180 days post-procedure, and at 7 days post-procedure a statistically significant reduction in cyst volume was observed (all patients: 96.8%; group A: 96%; group B: 97.6%). The reduced cyst volume was still observed 180 days post-procedure (all patients: 98.6%; group A: 98.2%; group B: 98.9%). There was no significant difference between the two treatment groups. Conclusion: There is a significant and persistent reduction in the volume of renal cysts, in addition to an improvement of the associated symptoms, after treatment with NBCA-based sclerotherapy, with or without hydrodissection.
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Affiliation(s)
| | - Mario I. Ortiz
- Academic Area of Medicine. Universidad Autónoma del Estado de Hidalgo. Pachuca, Hidalgo, CP 42160, Mexico
| | - Jeannett Izquierdo-Vega
- Academic Area of Medicine. Universidad Autónoma del Estado de Hidalgo. Pachuca, Hidalgo, CP 42160, Mexico
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Figaro N, Rampersad R, Juman S. Doxycycline Sclerotherapy of a Cervical Cystic Hygroma: A Caribbean Institution Experience. Case Rep Otolaryngol 2020; 2020:9187205. [PMID: 33014495 PMCID: PMC7512093 DOI: 10.1155/2020/9187205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 08/17/2020] [Accepted: 08/29/2020] [Indexed: 11/18/2022] Open
Abstract
Cervical cystic lymphangiomas are rare benign tumors that pose a formidable challenge to surgeons confronted with managing this uncommon entity. Due to the intimacy with which these cystic lesions blend with critical cervical structures, a considerable number of patients who undergo surgical management are often plagued with recurrence and morbidity. As a result, doxycycline sclerotherapy has become an attractive, safe, and effective alternative as a primary treatment modality in a select group of pediatric patients. This case report presents an 18-month-old patient with a large cervical cystic hygroma that was effectively treated with exclusive doxycycline sclerotherapy.
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Affiliation(s)
- Nicholas Figaro
- Department of Clinical Surgical Sciences, University of the West Indies, Eric Williams Medical Sciences Complex, Champs Fleur, Trinidad and Tobago
| | - Robbie Rampersad
- Department of Radiology, University of the West Indies, Eric Williams Medical Sciences Complex, Champs Fleur, Trinidad and Tobago
| | - Solaiman Juman
- Department of Clinical Surgical Sciences, University of the West Indies, Eric Williams Medical Sciences Complex, Champs Fleur, Trinidad and Tobago
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Zhang X, Cao D, Han P, Ren Z, Wang J, Wei Q. Aspiration-sclerotherapy versus laparoscopic de-roofing in the treatment of renal cysts: which is better? BMC Nephrol 2020; 21:193. [PMID: 32448166 PMCID: PMC7245882 DOI: 10.1186/s12882-020-01832-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2019] [Accepted: 04/27/2020] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND To compare the clinical efficiency between aspiration-sclerotherapy (AS) and laparoscopic de-roofing (LD) in the management of renal cysts through meta-analysis of comparative studies. METHOD A comprehensive literature search was performed by PubMed, MEDLINE, Ovid and Web of Science for relevant studies published up to January 2020. The statistical analyses were conducted with Review Manager 5.3.0 and Stata 15.1. The sensitivity analysis was also carried out to confirm the reliability of this Meta-analysis. RESULTS Our searches of literature generated 6 studies (1547 patients incorporated) comparing AS with LD in the impacts of renal cyst therapy. Of these, 6 studies contained 1106 and 441 patients who were treated with AS and LD, respectively. The outcome of this meta-analysis indicated that LD group was superior in symptomatic successful rate [Odds Ratio (OR): 0.28; 95%Confidence Interval (CI): 0.09 to 0.86; P = 0.03), radiological successful rate (OR: 0.06; 95%CI: 0.02 to 0.15; P < 0.01) and recurrence rate (OR: 6.08; 95%CI: 2.81 to 13.15; p < 0.01). Nevertheless, AS group had shorter treatment time [Mean Difference (MD):-51.10; 95% CI:-73.01 to - 29.20; p < 0.01]. No statistically significant difference was showed in the rate of complications (OR: 3.19; 95% CI: 0.39 to 25.88; P = 0.28). CONCLUSIONS In our meta-analysis, LD had higher symptomatic successful rate, radiological successful rate as well as lower recurrence rate than AS, while the treatment time was longer.
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Affiliation(s)
- Xueling Zhang
- Department of Urology, West China Hospital, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, Sichuan, People's Republic of China
| | - Dehong Cao
- Department of Urology, West China Hospital, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, Sichuan, People's Republic of China
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu, 61000, People's Republic of China
| | - Peizhen Han
- Department of Urology, West China Hospital, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, Sichuan, People's Republic of China
| | - Zhengju Ren
- Department of Urology, West China Hospital, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, Sichuan, People's Republic of China
| | - Jia Wang
- Department of Urology, West China Hospital, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, Sichuan, People's Republic of China.
| | - Qiang Wei
- Department of Urology, West China Hospital, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, Sichuan, People's Republic of China.
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Low LS, Nair SM, Davies AJW, Akapita T, Holmes MA. Aspiration and sclerotherapy of hydroceles and spermatoceles/epididymal cysts with 100% alcohol. ANZ J Surg 2019; 90:57-61. [PMID: 31628703 DOI: 10.1111/ans.15467] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 08/14/2019] [Accepted: 08/21/2019] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To evaluate the efficacy of aspiration and sclerotherapy with 100% alcohol for the primary treatment of benign scrotal cysts. METHODS From March 2014 to March 2018, 114 patients were identified who underwent their first aspiration and sclerotherapy procedure (80 hydroceles and 34 spermatoceles/epididymal cysts). The procedure was carried out in the outpatient clinic with local anaesthesia. A 16-gauge IV catheter is used to puncture the sac under aseptic conditions. The volume of alcohol instilled was 10% of the aspirated volume (maximum of 50 mL). Patients were then observed in the waiting room and completed a questionnaire. Urology clinic follow up was scheduled at 6 weeks. RESULTS At follow up, 54 patients (67.5%) with hydroceles and 25 patients (73.5%) with spermatoceles/epididymal cysts had resolution after a single procedure. A second procedure was offered if fluid collection persisted, of which 71% of patients with hydroceles and 100% of patients with spermatoceles/epididymal cysts had a successful outcome. At a median of 31 months post-initial procedure, the overall success rate, after at most two procedures, was 80% for hydroceles and 85% for spermatoceles/epididymal cysts. The complication rate was low (6%). Almost all patients were happy to undergo the procedure again, if needed. Persistence following aspiration and sclerotherapy were more likely to occur in younger patients (45.4 versus 61.2 years, P = 0.001). Persistence was not related to the volume of fluid aspirated. CONCLUSION Aspiration and sclerotherapy with alcohol is a reliable, safe and effective technique for treatment of benign scrotal cysts.
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Affiliation(s)
- Li Sian Low
- Urology Department, Waikato District Health Board, Hamilton, New Zealand
| | - Shiva M Nair
- Urology Department, Waikato District Health Board, Hamilton, New Zealand
| | - Adam J W Davies
- Urology Department, Waikato District Health Board, Hamilton, New Zealand
| | - Teresa Akapita
- Urology Department, Waikato District Health Board, Hamilton, New Zealand
| | - Michael A Holmes
- Urology Department, Waikato District Health Board, Hamilton, New Zealand
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Bigliardi E, Cantoni AM, De Cesaris V, Denti L, Conti V, Bertocchi M, Di Ianni F, Parmigiani E, Grolli S. Use of platelet-rich plasma for the treatment of prostatic cysts in dogs. CANADIAN JOURNAL OF VETERINARY RESEARCH = REVUE CANADIENNE DE RECHERCHE VETERINAIRE 2018; 82:264-270. [PMID: 30363366 PMCID: PMC6168016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Accepted: 01/11/2018] [Indexed: 06/08/2023]
Abstract
Abnormalities of the canine prostate gland, in particular, benign hyperplasia and cysts, are frequent in dogs over 5 years of age. Treatment strategies for dogs with prostatic cysts include ultrasound-guided percutaneous drainage with alcohol sclerotherapy, reduction surgery, and omentalization. The aim of this study was to evaluate the use of platelet-rich plasma (PRP) for the treatment of prostatic cysts in dogs. Ten mixed breed adult male dogs were included in the study. Percutaneous drainage was performed prior to ultrasound-guided PRP injection with a 21G spinal needle. The PRP dose contained half of the solution drained from the cyst. Follow-ups were performed 6, 12, 24, and 60 d after treatment. Ten prostatic cysts were successfully treated with PRP after the ultrasound-guided drainage of the cystic cavities. No side effects were observed during the procedures. After the introduction of PRP, cysts detected by ultrasound appeared hypoechoic. On the sixth day, the hypoechoic appearance was maintained and margins were still identifiable. At 24-day and 60-day follow-ups, cysts were no longer detectable by ultrasound. One of the ten dogs had to be euthanized because of the presence of a malignant mesenchymal neoplasm of the oral cavity (fibroblastic sarcoma) and histological examination of serial sections of the prostate gland was performed. Histologic evaluation 1 year after treatment showed a regression of the cystic lesion injected with PRP. The therapy, which uses PRP injection in combination with ultrasound-guided drainage, can be considered a safe and effective strategy for the treatment of prostatic cysts in dogs.
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Affiliation(s)
- Enrico Bigliardi
- Department of Veterinary Medical Science, University of Parma, Via del Taglio 10, 43100 Parma, Italy
| | - Anna Maria Cantoni
- Department of Veterinary Medical Science, University of Parma, Via del Taglio 10, 43100 Parma, Italy
| | - Valeria De Cesaris
- Department of Veterinary Medical Science, University of Parma, Via del Taglio 10, 43100 Parma, Italy
| | - Laura Denti
- Department of Veterinary Medical Science, University of Parma, Via del Taglio 10, 43100 Parma, Italy
| | - Virna Conti
- Department of Veterinary Medical Science, University of Parma, Via del Taglio 10, 43100 Parma, Italy
| | - Mara Bertocchi
- Department of Veterinary Medical Science, University of Parma, Via del Taglio 10, 43100 Parma, Italy
| | - Francesco Di Ianni
- Department of Veterinary Medical Science, University of Parma, Via del Taglio 10, 43100 Parma, Italy
| | - Enrico Parmigiani
- Department of Veterinary Medical Science, University of Parma, Via del Taglio 10, 43100 Parma, Italy
| | - Stefano Grolli
- Department of Veterinary Medical Science, University of Parma, Via del Taglio 10, 43100 Parma, Italy
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13
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Wong W, Loya MF, Martynov A, Shah SS, Berman D. Successful sclerotherapy of a recurrent, benign parotid cyst. Radiol Case Rep 2017; 13:146-149. [PMID: 29552253 PMCID: PMC5850872 DOI: 10.1016/j.radcr.2017.09.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2017] [Revised: 08/26/2017] [Accepted: 09/05/2017] [Indexed: 02/02/2023] Open
Abstract
Benign parotid lesions can grow to be a cosmetic deformation with psychological sequelae for a patient. Although surgical resection is the treatment of choice, cyst aspiration has also been attempted. This, however, has been shown to recur, requiring repeat intervention. An alternative therapeutic method not as widely recognized, but which has been reported to be both effective and less invasive than surgery for treating parotid cyst lesions, is sclerotherapy. Here we describe a report of a patient with a benign, localized, cystic neck mass refractory to 2 trials of fine needle aspiration. After the patient refused surgical resection, a trial of sterile ethanol sclerotherapy was performed. Our patient tolerated the procedure well with a significant reduction in the size of the lesion.
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14
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Ćwik G, Wyroślak-Najs J, Solecki M, Wallner G. Evaluation of the utility value of percutaneous drainage of symptomatic hepatic cysts combined with an obliteration attempt. J Ultrason 2016; 16:260-72. [PMID: 27679729 PMCID: PMC5034020 DOI: 10.15557/jou.2016.0026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Revised: 03/16/2016] [Accepted: 03/23/2016] [Indexed: 12/03/2022] Open
Abstract
Aim The goal of the paper was to evaluate the procedure of percutaneous drainage of symptomatic hepatic cysts under the transabdominal ultrasound control combined with obliteration. Material and method Within the period from 2005 to 2015, 70 patients diagnosed with a simple hepatic cyst of symptomatic nature were subject to hospitalization and treated at the 2nd General, Gastroenterological and Cancer Surgery of the Alimentary System Center and Clinics of the Medical University of Lublin. All the patients subject to evaluation were qualified to percutaneous drainage under an ultrasound control. The drainage utilized typical sets of drains with the diameter of at least 9 F, most often of pigtail type. The fluid aspirated form the cyst was dispatched for complex laboratory testing. Further, a 10% sodium chloride solution was administered to the cyst through the drain, in the volume depending on the previous size of the cyst and the patient's reaction. Results Patients reported for a re-visit within the period from 3 to 9 months following the procedure. Complete obliteration of the cyst was confirmed only in 8 patients (11%). Cyst recurrence was reported in cases when during the ultrasound evaluation, the diameter of the cyst following aspiration and obliteration enlarged to over 75% of the initial dimension. In this group, in 10 out of 12 examined (83%) there was a relapse of the previously observed ailments. Among patients, who has a cyst imaged within the period of observation, which had the diameter from 50% to 75% of the previous size, only in 6 cases (37.5%) the initial symptoms relapsed. Conclusions The utilization of a drainage and obliteration enables one to achieve the acceptable result of the therapy as well as significant decrease in the number of previously reported ailments and symptoms described.
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Affiliation(s)
- Grzegorz Ćwik
- II Chair and Department of General, and Gastroenterological Surgery and Surgical Oncology of the Alimentary Tract, Medical University of Lublin, Poland
| | - Justyna Wyroślak-Najs
- II Chair and Department of General, and Gastroenterological Surgery and Surgical Oncology of the Alimentary Tract, Medical University of Lublin, Poland
| | - Michał Solecki
- II Chair and Department of General, and Gastroenterological Surgery and Surgical Oncology of the Alimentary Tract, Medical University of Lublin, Poland
| | - Grzegorz Wallner
- II Chair and Department of General, and Gastroenterological Surgery and Surgical Oncology of the Alimentary Tract, Medical University of Lublin, Poland
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15
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Slaoui A, Regragui S, Lasri A, Karmouni T, El Khader K, Koutani A, Ibn Attya A. Zinner's syndrome: report of two cases and review of the literature. Basic Clin Androl 2016; 26:10. [PMID: 27672439 PMCID: PMC5028972 DOI: 10.1186/s12610-016-0037-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Accepted: 08/17/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Congenital malformations of the seminal vesicle are uncommon, and most of them are cystic malformations. If an insult occurs between the 4th and the 13 h gestational week, the embryogenesis of the kidney, ureter, seminal vesicle, and vas deferens could be altered. Cysts of the seminal vesicle may appear with a mass effect, dysuria, epididymitis, or obstruction of the gastrointestinal and genitourinary tracts. Approximately two thirds of them are associated with ipsilateral renal agenesis, because both the ureteral buds and seminal vesicles originate from the mesonephric (Wolffian) duct. They were first described by Zinner in 1914, and 200 cases of seminal vesicle cysts associated with ipsilateral renal agenesis have been reported in the literature. Most patients with this anomaly are asymptomatic until the third or fourth decade of life. Some cases have nonspecific symptoms such as prostatism, urinary urgency, dysuria, painful ejaculation, and perineal discomfort. Transrectal ultrasonography provides good visualization of the pelvic structures and allows guidance for aspiration of the cysts. CASE PRESENTATION We present two cases of seminal vesicle cyst. The first patient had dysuria, increased frequency of urination, and haematuria. He was operated and benefited from a removal of the cyst with right ureterectomy and left ureteral reimplantation. The second patient had disorder of the digestive transit and he benefited from a laparoscopic removal of the cyst. CONCLUSIONS Seminal vesicle cysts combined with ipsilateral renal agenesis are rare urological anomalies. Usual symptoms that are caused by the seminal vesicle cysts are bladder irritation and obstruction as well as pain in the perineum and scrotum. Epididymitis is frequently found. Treatment consists to removing the seminal vesicle cyst.
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Affiliation(s)
- Amine Slaoui
- Urology B Ibn Sina Hospital, Mohammed V University, Rabat, Morocco
| | - Souhail Regragui
- Urology B Ibn Sina Hospital, Mohammed V University, Rabat, Morocco
| | | | - Tarik Karmouni
- Urology B Ibn Sina Hospital, Mohammed V University, Rabat, Morocco
| | - Khalid El Khader
- Urology B Ibn Sina Hospital, Mohammed V University, Rabat, Morocco
| | | | - Ahmed Ibn Attya
- Urology B Ibn Sina Hospital, Mohammed V University, Rabat, Morocco
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16
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Larssen TB, Viste A, Horn A, Haldorsen IS, Espeland A. Single-session alcohol sclerotherapy of symptomatic liver cysts using 10-20 min of ethanol exposure: no recurrence at 2-16 years of follow-up. Abdom Radiol (NY) 2016; 41:1776-81. [PMID: 27156079 PMCID: PMC5002038 DOI: 10.1007/s00261-016-0769-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
PURPOSE To assess long-term results after single-session alcohol sclerotherapy of symptomatic benign liver cysts performed with maximum 20 min of exposure to alcohol. METHODS We included 47 patients aged 32-88 years (42 women, 5 men) with 51 benign non-parasitic liver cysts that were exposed to ethanol for 7-20 min in a single sclerotherapy session and were followed for at least 24 months. Each cyst was emptied before injecting ethanol (10% of cyst volume, but maximum 100 mL) into it. The patient rotated from side to side to facilitate contact between ethanol and the whole cyst wall. Pre-treatment cyst volume was defined as the volume of aspirated cyst fluid after complete emptying of the cyst. Follow-up cyst volume was estimated based on computed tomography images. RESULTS Cyst volumes were 30-4900 (median 520) mL at pre-treatment and 0-230 (median 1) mL at 24-193 (median 56) months follow-up, a reduction of 83-100% (median 99.7%). No cyst required repeated treatment during the follow-up. Median volume reduction was 99.7% at median 49 months of follow-up for 35 cysts exposed to ethanol for 7-10 min vs. 99.6% at median 75 months of follow-up for 16 cysts exposed for 20 min (p = 0.83, Mann-Whitney test). Ethanol intoxication occurred in one patient. There were no other complications except for pain. CONCLUSION Long-term results of single-session alcohol sclerotherapy performed with maximum 20 min of exposure to ethanol were satisfactory with no sign of recurrence of cyst fluid.
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Affiliation(s)
- Trond Bjerke Larssen
- Department of Radiology, Haukeland University Hospital, Jonas Liesvei 65, 5021, Bergen, Norway
- Department of Clinical Medicine, University of Bergen, Pb 7804, 5020, Bergen, Norway
| | - Asgaut Viste
- Department of Clinical Medicine, University of Bergen, Pb 7804, 5020, Bergen, Norway
- Department of Acute and Gastrointestinal Surgery, Haukeland University Hospital, Jonas Liesvei 65, 5021, Bergen, Norway
| | - Arild Horn
- Department of Acute and Gastrointestinal Surgery, Haukeland University Hospital, Jonas Liesvei 65, 5021, Bergen, Norway
| | - Ingfrid Salvesen Haldorsen
- Department of Radiology, Haukeland University Hospital, Jonas Liesvei 65, 5021, Bergen, Norway
- Department of Clinical Medicine, University of Bergen, Pb 7804, 5020, Bergen, Norway
| | - Ansgar Espeland
- Department of Radiology, Haukeland University Hospital, Jonas Liesvei 65, 5021, Bergen, Norway.
- Department of Clinical Medicine, University of Bergen, Pb 7804, 5020, Bergen, Norway.
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17
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Lymphatic Embolization for the Treatment of Pelvic Lymphoceles: Preliminary Experience in Five Patients. J Vasc Interv Radiol 2016; 27:1170-6. [DOI: 10.1016/j.jvir.2016.04.011] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2016] [Revised: 04/12/2016] [Accepted: 04/12/2016] [Indexed: 12/27/2022] Open
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18
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Copley PC, Ali L, Mirza S. Spontaneous lymphocoele: an unusual cause of an axillary mass. BMJ Case Rep 2016; 2016:bcr-2015-213088. [PMID: 26869624 DOI: 10.1136/bcr-2015-213088] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
A lymphocoele or cystic hygroma is a benign lymphatic malformation that usually presents as a congenital mass in infancy. These masses are most common in the cervicofacial region and more rarely occur elsewhere in the body. Spontaneous, atraumatic presentation in adulthood is extremely rare. We present a case of a 59-year-old woman who presented with a fluctuant mass in the axilla, which was diagnosed as a lymphocoele. Initial management by ultrasound-guided aspiration of the cyst proved unsuccessful due to recurrence. Surgical excision of the cyst was then successfully performed and histological analysis proved the diagnosis. The incidence of adult-onset lymphocoele without a history of prior trauma or operation is rare. This case report adds to the literature and reviews the various management strategies that have been successfully employed.
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Affiliation(s)
| | - Liaqat Ali
- Department of Breast Surgery, Hinchingbrooke Hospital, Huntingdon, Cambridgeshire, UK
| | - Shaukat Mirza
- Department of Trauma & Orthopaedics, Addenbrooke's Hospital, Cambridge, UK
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Fernández Martínez A, López González L, Santana-Lopez G, Álvarez Silva I, Cuesta Marcos T. Clinical usefulness of ultrasound-guided alcohol sclerosis in patients with breast fistulas. RADIOLOGIA 2015. [DOI: 10.1016/j.rxeng.2014.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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20
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Fernández Martínez AM, López González L, Santana-Lopez G, Álvarez Silva I, Cuesta Marcos T. [Clinical usefulness of ultrasound-guided alcohol sclerosis in patients with breast fistulas]. RADIOLOGIA 2014; 57:321-5. [PMID: 25074034 DOI: 10.1016/j.rx.2014.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2014] [Revised: 05/12/2014] [Accepted: 05/27/2014] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To study the clinical usefulness of ultrasound-guided alcohol sclerosis as a treatment alternative to surgical intervention for breast fistulas. MATERIAL AND METHODS This was a retrospective study of data collected in a hospital breast unit over a three-year period (January 2011 through December 2013). The procedure consists of introducing a sclerosing solution into the lumen of the breast fistula under ultrasound guidance. All cases were reviewed by a multidisciplinary committee; patients were offered ultrasound-guided alcohol sclerosis as a first treatment option with surgical intervention as a rescue therapy for those with unsatisfactory outcomes. RESULTS Ten fistulas were treated in 9 women (median age, 33 y; interquartile range 18.5 y). Five patients (50%) attributed the clinical findings to recurrent mastitis, four (40%) to a previous surgical intervention, and one (10%) to lactation. Seven patients (78%) were smokers. The procedure was well tolerated: nine patients (90%) rated the pain as one or 2 (mild pain) on a visual analogue scale. There were no immediate complications. The response to treatment was considered excellent (absence of secretion and complete closure) in eight fistulas (80%). CONCLUSION Ultrasound-guided alcohol sclerosis achieved excellent outcomes in 80% of cases and is a viable alternative to surgical treatment.
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Affiliation(s)
| | - L López González
- Servicio de Radiodiagnóstico, Complejo Asistencial Universitario de León, León, España
| | - G Santana-Lopez
- Servicio de Medicina Preventiva, Hospital Universitario de Gran Canaria Doctor Negrín, Las Palmas de Gran Canaria, España
| | - I Álvarez Silva
- Servicio de Radiodiagnóstico, Complejo Asistencial Universitario de León, León, España
| | - T Cuesta Marcos
- Servicio de Radiodiagnóstico, Complejo Asistencial Universitario de León, León, España
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