Objective To evalute the cl inical outcomes of two different surgical treatments for arachnoid cysts in sacral canal. Methods From January 2004 to March 2009, 55 cases of arachnoid cysts in the sacral canal were treated by traditonal simple sacral laminectomies with resection of the cysts (group A, 25 cases) and novel CT-guided percutaneous fibrin glue therapy of arachnoid cysts (group B, 30 cases). Of them, there were 23 males and 32 females, aging 15-66 years with an average of 42.6 years; the duration of symptoms was 6 months to 15 years with an average of 3.5 years. L5-S1 was involved in 22 cases, S1,2 in 25 cases, S2,3 in 12 cases, S2 in 8 cases, and presacral in 2 cases. The size of cysts was 1.5 cm × 1.0 cm to 6.0 cm × 2.8 cm. The MRI examination showed that all patients had cysts in the sacral canal. There were no significant difference (P gt; 0.05) in sex, ages, disease duration and cysts size between two groups. Preoperative data and postoperative lumbosacral pain and function improvement were analyzed and compared between two groups. Results All operations were performed successfully. The operative time, blood loss and hospital ization days of group B were significantly less than those of group A (P lt; 0.01). All 55 cases were followed up from 9 to 61 months (mean 23 months). In group A, postoperative cerebrospinal fluid leakage (25 cases), intracranial infection (2 cases), nerve injury (3 cases), and nerve root irritation (8 cases) occurred; in group B, mild meningitis (3 cases) and low grade fever (5 cases) occurred. Except for nerve injury, other compl ications were cured after symptomatic management. During the follow-up, 2 recurrent cases were found in group A and 1 case in group B. Of them, 2 recurrent cases were treated with CT-guided percutaneous fibrin glue therapy of arachnoid cysts, and cysts disappeared. For two groups, there were significant differences in Oswestry functional disabil ity index and visual analogue scale score between preoperation and postoperation (P lt; 0.01), and in the rate of score improvement between two groups (P lt; 0.01). According to the rating scale, the excellent and good rates of pain improvement were 64% in group A and 100% in group B; the excellent and good rates of function improvement were 24% in group A and 97% in group B. Conclusion CT-guided percutaneous fibrin glue therapy for arachnoid cysts in the sacral canal is a mini-invasive, safe, effective, and economical method, it may be better choices for the treatment of arachnoid cysts in the sacral canal.
目的 探索无法行手术及化放疗等治疗措施的原发性周围性肺癌患者行微波消融治疗的安全性及效果。 方法 我院 2013 年 12 月至 2015 年 11 月 39 例原发性肺癌患者（其中男 24 例、女 15 例，年龄 44～83 岁，中位年龄 67 岁）行微波消融治疗，肿瘤平均直径 3.5 cm。评价肿瘤局部疗效，随访时间 0.5～2.0 年。 结果 全组 39 例患者进行病灶消融后，病灶立即均质化，CT 值下降，供血终止，6 个月后病灶开始逐步缩小，瘢痕化。随访 39 例患者中有 3 例手术后生存 1.0～1.5 年因肿瘤全身广泛转移死亡；2 例患者手术后 6 个月复查增强 CT 见局部有少许血供予以再次消融；全组患者无 1 例严重并发症发生。 结论 微波消融对原发性小细胞肺癌患者的治疗效果佳、创伤小、手术风险小、安全性高。
Objective To investigate the clinical value and complication factors of percutaneous transthoracic needle biopsy (PTNB) guided by multislice computed tomography (MSCT). Methods From January 2013 to December 2016, 179 patients treated with MSCT-guided lung biopsy in the Affiliated Hospital of North Sichuan Medical College and Dianjiang People’s Hospital were reviewed. Occurrence rate and the influencing factors of complications were analyzed. Meanwhile, biopsy findings and diagnostic accuracy rate were summarized. Results A total of 129 cases of lung cancer were detected under MSCT-guided percutaneous biopsy in 179 patients with a diagnostic accuracy of 93.30%. The correct rate of malignant tumor diagnosis was 92.14%. The main complications were pneumothorax, pulmonary hemorrhage, dyspnea and hemoptysis. Major risk factors of MSCT-guided PTNB complications included lesion size ≤ 2 cm, the shortest distance to the diaphragm ≤ 5 cm, puncture depth > 5 cm, pleural puncture angle > 50°, the puncture times ≥ 2, puncture time ≥ 20 minutes, age of patients > 60 years, and existence of pulmonary disease (P<0.05). Conclusions The clinical application value of MSCT-guided PTNB is high. Skilled puncture technique and appropriate puncture procedure are helpful to reduce complications.
The iodine-125 (125I) seeds interstitial implantation has the advantages of minimal invasiveness, high local control rate, and few complications; it has attracted worldwide attention. With the application of 3D printing technology in medicine, individualized 3D templates are gradually applied to clinical practice. Individualized 3D templates combining with CT-guided 125I seeds implantation are easy to operate and can not only effectively ensure the consistency and accuracy of preoperative and postoperative dose, but also minimize complications to achieve optimal efficacy. This paper reviews the application of CT-guided implantation of 125I seeds for malignant tumors assisted by individualized 3D template, and further demonstrates the safety and effectiveness of clinical application in 125I seeds implantation to provide a reliable basis for the standardization of 125I seeds implantation.
ObjectiveTo compare the effectiveness and safety of electromagnetic navigation-guided localization and CT-guided percutaneous localization for pulmonary nodules.MethodsThe literature published from the inception to January 2021 about the comparison between electromagnetic navigation-guided localization and CT-guided percutaneous localization for pulmonary nodules in the PubMed, The Cochrane Library, Web of Science, EMbase, Chinese Wanfang database and CNKI database was searched. RevMan (version 5.4) software was used for meta-analysis. Nonrandomized controlled trials were evaluated using methodological index for nonrandomized studies (MINORS).ResultsA total of six retrospective studies (567 patients) were included in this meta-analysis. MINORS scores of all studies were all 17 points and above. There were 317 patients in the CT-guided percutaneous localization group and 250 patients in the electromagnetic navigation-guided localization group. The complication rate of the CT-guided percutaneous localization group was significantly higher than that in the electromagnetic navigation-guided localization group (OR=11.08, 95%CI 3.35 to 36.65, P<0.001). There was no significant difference in the success rate of localization (OR=0.48, 95%CI 0.16 to 1.48, P=0.20), localization time (MD=0.30, 95%CI –6.16 to 6.77, P=0.93) or nodule diameter (MD=–0.07, 95%CI –0.19 to 0.06, P=0.29) between the two groups.ConclusionElectromagnetic navigation can be used as an effective preoperative positioning method for pulmonary nodules, which has the advantage of lower complication rate compared with the traditional CT positioning method.